51Atrial fibrillation: 10 - year trends in epidemiology and prognosis for patients hospitalized in the Silesia region

Background: The atrial fibrillation is the most common arrhythmia in the developed countries, significantly influencing the patients prognosis and healthcare system burden. The previously published data haven’t included the regional specific and the long-term prevalence trends and potential risks of adverse events associated with AF data are scarce. The goal of our analysis is the evaluation of 10 – year trends of prevalence of atrial fibrillation in the Silesian population and related morbidity and mortality. Methods: The analysis was based on the population of Silesian Heart –Vessel Database (SILICARD), with follow - up gathered from the data of National Health Found (Narodowy Fundusz Zdrowia, NFZ), the polish only national healthcare provider. In the general rules, the hospitals and ambulatory clinics for every medical contact or hospitalization refer to the NFZ the main diagnosis and up to two co-morbidities defined coded with ICD-10 code key. The inclusion criteria into SILACRD database were: any hospitalization in the department of cardiology, cardiac surgery, diabetology or vessel surgery or the hospitalization with the cardiological diagnosis (based on ICD – 10 codes) in the internal medicine department or intensive care unit or the hospitalization for stroke in neurology department. The patients were recruited from Silesia, highly urbanized region in Poland with more than 4,5 millions of citizens. The data were obtained from 310 hospital departments and 1863 outpatient (ambulatory) clinics. We analyzed 547285 patients hospitalized for the first time in the period 2006 -2015. Results: Based on 10 – year population observation we observed the significant increase of prevalence of atrial fibrillation diagnosis (ICD-10 code: I 48) as the first (main) or the co-morbidities diagnosis in patients hospitalized for the first time with the trend toward higher in-hospital (4.6% vs 6.0%) and one – year mortality in patients with ICD-48 code as one of the referred diagnoses (as primary or secondary) (Figure 1). We observed significant reduction of rehospitalizations (P<0.001) without significant changes in prevalence of stroke in one –year follow-up. However, in patients with primary diagnosis code of I48 the significant trend in reduction on in-hospital mortality (1.1% vs 0.6%, P<0.001) was shown. The demographic data have changed in 10 – year period: the patients were older, the mean cost of treatment for national health found has increased, however with shortened mean hospitalization time. Conclusions: The treatment of patients with atrial fibrillation is one of the more important clinical problem in Silesia, with increasing burden of healthcare system burden. Despite the improvement in diagnostic procedures and pharmacotherapy, the overall mortality of patients with diagnosis of AF constantly increase. Abstract 51 Figure.