Abstract：
Atrial fibrillation (AF) is the most common cardiac arrhythmia, with an increasing incidence and prevalence because of progressively aging populations. Costs related to AF are both direct and indirect. This systematic review aims to identify the main cost drivers of the illness, assess the potential economic impact resulting from changes in care strategies, and propose interventions where they are most needed.
A systematic literature search of the PubMed and Scopus databases was performed to identify analytical observational studies defining the cost of illness in cases of AF. The search strategy was based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 recommendations.
Of the 944 articles retrieved, 24 met the inclusion criteria. These studies were conducted in several countries. All studies calculated the direct medical costs, whereas 8 of 24 studies assessed indirect costs. The median annual direct medical cost per patient, considering all studies, was €9409 (13 333 US dollars in purchasing power parities), with a very large variability due to the heterogeneity of different analyses. Hospitalization costs are generally the main cost drivers. Comorbidities and complications, such as stroke, considerably increase the average annual direct medical cost of AF.
In most of the analyzed studies, inpatient care cost represents the main component of the mean direct medical cost per patient. Stroke and heart failure are responsible for a large share of the total costs; therefore, implementing guidelines to manage comorbidities in AF is a necessary step to improve health and mitigate healthcare costs.
A systematic literature search of the PubMed and Scopus databases was performed to identify analytical observational studies defining the cost of illness in cases of AF. The search strategy was based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 recommendations.
Of the 944 articles retrieved, 24 met the inclusion criteria. These studies were conducted in several countries. All studies calculated the direct medical costs, whereas 8 of 24 studies assessed indirect costs. The median annual direct medical cost per patient, considering all studies, was €9409 (13 333 US dollars in purchasing power parities), with a very large variability due to the heterogeneity of different analyses. Hospitalization costs are generally the main cost drivers. Comorbidities and complications, such as stroke, considerably increase the average annual direct medical cost of AF.
In most of the analyzed studies, inpatient care cost represents the main component of the mean direct medical cost per patient. Stroke and heart failure are responsible for a large share of the total costs; therefore, implementing guidelines to manage comorbidities in AF is a necessary step to improve health and mitigate healthcare costs.
摘要：
目的：心房颤动（房颤）是最常见的心律失常，由于人口逐渐老龄化，发病率和患病率不断增加。与AF相关的成本是直接的和间接的。这项系统评价旨在确定疾病的主要成本驱动因素，评估护理策略变化带来的潜在经济影响，并在最需要的地方提出干预措施。
方法：对PubMed和Scopus数据库进行了系统的文献检索，以确定确定房颤病例中疾病成本的分析观察性研究。搜索策略基于PRISMA2020建议。
结果：在检索到的944篇文章中，24符合纳入标准。这些研究在几个国家进行。所有研究都计算了直接医疗费用，24项研究中有8项评估了间接成本。每位患者的年度直接医疗费用中位数，考虑到所有的研究，为9,409欧元（13,333美元的购买力平价），由于不同分析的异质性，差异很大。住院费用通常是主要的费用驱动因素。合并症和并发症，如中风，大大增加了房颤的年平均直接医疗费用。
结论：在大多数分析研究中，住院护理成本是每位患者平均直接医疗成本的主要组成部分。中风和心力衰竭占总成本的很大一部分；因此，实施准则来管理房颤患者的合并症是改善健康和降低医疗成本的必要步骤.
方法：对PubMed和Scopus数据库进行了系统的文献检索，以确定确定房颤病例中疾病成本的分析观察性研究。搜索策略基于PRISMA2020建议。
结果：在检索到的944篇文章中，24符合纳入标准。这些研究在几个国家进行。所有研究都计算了直接医疗费用，24项研究中有8项评估了间接成本。每位患者的年度直接医疗费用中位数，考虑到所有的研究，为9,409欧元（13,333美元的购买力平价），由于不同分析的异质性，差异很大。住院费用通常是主要的费用驱动因素。合并症和并发症，如中风，大大增加了房颤的年平均直接医疗费用。
结论：在大多数分析研究中，住院护理成本是每位患者平均直接医疗成本的主要组成部分。中风和心力衰竭占总成本的很大一部分；因此，实施准则来管理房颤患者的合并症是改善健康和降低医疗成本的必要步骤.
