Cotté Francois-Emery, Chaize Gwendoline, Gaudin Anne-Françoise, Samson Adeline, Vainchtock Alexandre, Fauchier Laurent
Bristol-Myers Squibb, Health Economics & Outcomes Research, Rueil-Malmaison, France
HEVA, Lyon, France.
Europace. 2016 Apr;18(4):501-7. doi: 10.1093/europace/euv248. Epub 2015 Dec 30.
Atrial fibrillation (AF) is associated with numerous cardiovascular complications. We sought to estimate the annual burden of cardiovascular complications in AF patients in French hospitals.
All AF patients hospitalized in France in 2012 were identified from the national public/private hospital database. Comorbid conditions and medical histories were documented using medical records dating back 5 years. Reasons for hospitalization, type of admission (emergency or otherwise), length of stay, rehabilitation transfers, and death at discharge were identified and costs of acute and rehabilitation care determined (2012 Euros). In total, 533 044 AF patients (mean age ± SD 78.0 ± 11.4 years, 47.1% women) were hospitalized in 2012 for any reason. Hospitalizations were cardiovascular-related in 267 681 patients [22.5% cardiac dysrhythmia, 18.3% heart failure, 7.1% vascular/ischaemic diseases, 6.9% stroke/transient ischaemic attack (TIA)/systemic embolism (SE), and 1.3% haemorrhages]. Patients with stroke/TIA/SE had higher rates of emergency admission (68.1%), transfer to rehabilitation unit (28.1%), and death at discharge (13.7%) than those with other cardiovascular complications, with the exception of haemorrhages, where emergency admission rates were similar. They also had longer mean lengths of stay (12.6 ± 13.2 days for acute care and 46.8 ± 42.5 days for rehabilitation). The annual total cost (acute care and rehabilitation) for all hospitalized cardiovascular events was €1.94 billion, of which heart failure represented €805 million, vascular/ischaemic diseases €386 million, stroke €362 million, cardiac dysrhythmia €341 million, and haemorrhage €48 million.
Half a million patients with AF were hospitalized in France in 2012. Cardiovascular-related hospitalizations involved half of these admissions, for a global burden of almost €2 billion, equivalent to 2.6% of total expenditure in French hospitals. Among these hospitalizations stroke/TIA/SE represented costly, but potentially preventable, complications.
心房颤动（AF）与众多心血管并发症相关。我们试图估算法国医院中AF患者心血管并发症的年度负担。
从国家公立/私立医院数据库中识别出2012年在法国住院的所有AF患者。使用可追溯5年的病历记录并存疾病和病史。确定住院原因、入院类型（急诊或其他）、住院时间、康复转诊情况以及出院时的死亡情况，并确定急性和康复治疗费用（2012年欧元）。2012年，共有533044例AF患者（平均年龄±标准差78.0±11.4岁，47.1%为女性）因任何原因住院。267681例患者的住院与心血管相关[22.5%为心律失常，18.3%为心力衰竭，7.1%为血管/缺血性疾病，6.9%为中风/短暂性脑缺血发作（TIA）/系统性栓塞（SE），1.3%为出血]。与其他心血管并发症患者相比，中风/TIA/SE患者的急诊入院率（68.1%）、转至康复病房的比例（28.1%）和出院时的死亡率（13.7%）更高，但出血患者除外，其急诊入院率相似。他们的平均住院时间也更长（急性治疗为12.6±13.2天，康复治疗为46.8±42.5天）。所有住院心血管事件的年度总费用（急性治疗和康复）为19.4亿欧元，其中心力衰竭为8.05亿欧元，血管/缺血性疾病为3.86亿欧元，中风为3.62亿欧元，心律失常为3.41亿欧元，出血为4800万欧元。
2012年法国有50万AF患者住院。与心血管相关的住院病例占这些入院病例的一半，总负担近20亿欧元，相当于法国医院总支出的2.6%。在这些住院病例中，中风/TIA/SE是代价高昂但可能可预防的并发症。
