Lee Cheng-Han, Liu Ping-Yen, Tsai Liang-Miin, Tsai Wei-Chuan, Ho Ming-Tsung, Chen Jyh-Hong, Lin Li-Jen
Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
Am J Med. 2007 Sep;120(9):819.e1-7. doi: 10.1016/j.amjmed.2006.10.014. Epub 2007 Aug 2.
The aim of the study is to describe the nationwide epidemiological data for hospitalized patients with atrial fibrillation in Taiwan.
We collected information on hospitalized patients with discharge-diagnosed atrial fibrillation from 1997 through 2002 from the Taiwan National Health Insurance database. Patients were examined for temporal trends in the frequency of the disease, clinical characteristics, and in-hospital mortality.
Of 162,340 patients (mean age, 73.8 years), 55.3% were men and 38.6% had a primary diagnosis of atrial fibrillation. The mean annual frequency of diagnosed atrial fibrillation was 127 per 100,000 persons. The frequency of atrial fibrillation rose from 91 (1997) to 150 (2002) per 100,000 persons (P <.001); it significantly increased directly with age from 4 per 100,000 in patients <50 years to 1571 per 100,000 in patients > or =80 years. The frequency was significantly higher in men than in women (137 vs 116 per 100,000; P <.001). The average in-hospital mortality rate was 9.3%. In-hospital mortality rate showed a decreasing trend (9.9% vs 7.6%; P = .003). Comorbidities of ischemic heart disease, valvular heart disease, hypertension, ischemic stroke, and congestive heart failure were predictors of higher mortality.
This Taiwanese study showed a 1.65-fold increase in the frequency of diagnosed atrial fibrillation during the study period. The in-hospital mortality rate, however, declined. The frequency of atrial fibrillation was higher in men and the elderly. We should be more concerned about negative outcomes in hospitalized patients with atrial fibrillation and other coexisting cardiovascular conditions.
本研究旨在描述台湾地区住院房颤患者的全国性流行病学数据。
我们从台湾全民健康保险数据库收集了1997年至2002年出院诊断为房颤的住院患者信息。对患者的疾病发生频率、临床特征和住院死亡率的时间趋势进行了研究。
在162340例患者(平均年龄73.8岁)中,55.3%为男性,38.6%的主要诊断为房颤。房颤的年诊断频率为每10万人127例。房颤的发生频率从每10万人91例(1997年)上升至每10万人150例(2002年)(P<.001);随年龄显著增加,<50岁患者每10万人中有4例,≥80岁患者每10万人中有1571例。男性的发生频率显著高于女性(每10万人137例对116例;P<.001)。平均住院死亡率为9.3%。住院死亡率呈下降趋势(9.9%对7.6%;P=.003)。缺血性心脏病、瓣膜性心脏病、高血压、缺血性中风和充血性心力衰竭的合并症是死亡率较高的预测因素。
这项台湾地区的研究表明,在研究期间,房颤的诊断频率增加了1.65倍。然而,住院死亡率有所下降。房颤在男性和老年人中更为常见。我们应该更加关注合并其他心血管疾病的住院房颤患者的不良结局。