The Effect of Atrial Fibrillation on Stroke-Related Inpatient Costs in Sweden: A 3-Year Analysis of Registry Incidence Data from 2001

Abstract

AF-related strokes are associated with higher 3-year inpatient costs than non-AF strokes when controlling for factors such as case fatality rates, other risk factors for stroke, and age.

Acute Hospital, Community, and Indirect Costs of Stroke Associated With Atrial Fibrillation

“…12 An analysis from the Swedish Riks-Stroke hospital registry also reported greater acute hospital costs with AF-stroke. 13 Other studies have reported AF-stroke costs as subgroups of cardioembolic stroke or all AF-related costs. 14,15 Although providing valuable information, these studies have excluded patients with stroke and paroxysmal AF, or those with recurrent stroke (which may account for up to one fifth of all AF-stroke), and costs unrelated to acute hospitalization were not described.…”

“…[12][13][14][15] One study from Germany reported that higher hospital costs were associated with AF-stroke but included only selected hospital-admitted, nonaphasic patients surviving without severe disability at 1 year to provide follow-up interviews. 12 An analysis from the Swedish Riks-Stroke hospital registry also reported greater acute hospital costs with AF-stroke.…”

“…We found substantially higher costs than previously describedthe mean 2-year cost in our study was €56 000 ($76 720) compared with €11 799 ($16 125; 1-year, direct costs) and €10 192 ($13 963; 3-year direct hospital costs) in Germany and Sweden. 12,13 A recently published retrospective study estimated 2-year direct costs of up to €29 700 ($40 689). 24 However, cost comparisons across studies must be interpreted with caution because of differing methods and variability in costs compared with time and in different healthcare systems.…”

“…In contrast to previous studies, we included patients with AF before stroke onset, new AF detected at stroke onset, and paroxysmal AF detected after stroke, leading to higher rates of AF in our cohort than previously described (31% compared with 19%-24% in earlier studies). 12,13 We included patients with severe stroke and early fatality in our primary analysis and performed sensitivity analyses to ensure our findings were robust in clinically relevant subgroups.…”

“…[6][7][8][9] Existing hospital-based studies have described high costs of stroke associated with AF. [10][11][12][13][14][15] However, existing studies have been limited by the reporting of acute hospital costs only, or by the inclusion of selected AF-stroke subgroups, such as hospitalized patients, nonaphasic patients, those with first-ever stroke only, or 1-year survivors. No cost studies of AF-stroke have been performed in unselected patients, including costs of community healthcare and indirect costs associated with lost productivity, leading to substantial underestimation of the Background and Purpose-No economic data from population-based studies exist on acute or late hospital, community, and indirect costs of stroke associated with atrial fibrillation (AF-stroke).…”