Dataset Information

Association of atrial fibrillation with outcomes in patients hospitalized with inflammatory bowel disease: an analysis of the National Inpatient Sample.

ABSTRACT:

Introduction

We aimed to determine in-hospital outcomes, length of hospital stay (LOS) and resource utilization in a contemporary cohort of patients with inflammatory bowel disease (IBD) and atrial fibrillation (AFIB).

Material and methods

The National Inpatient Sample database October 2015 to December 2017 was utilized for data analysis using the International Classification of Diseases, Tenth Revision codes to identify the patients with the principal diagnosis of IBD.

Results

Of 714,863 IBD patients, 64,599 had a diagnosis of both IBD and AFIB. We found that IBD patients with AFIB had a greater incidence of in-hospital mortality (OR = 1.3; 95% CI: 1.1-1.4), sepsis (OR = 1.2; 95% CI: 1.1-1.3), mechanical ventilation (OR = 1.2; 95% CI: 1.1-1.5), shock requiring vasopressor (OR = 1.4; 95% CI: 1.1-1.9), lower gastrointestinal bleeding (LGIB) (OR = 1.09, 95% CI: 1.04-1.1), and hemorrhage requiring blood transfusion (OR = 1.2, 95% CI: 1.17-1.37). Mean LOS ± SD, mean total charges and total costs were higher in patients with IBD and AFIB.

Conclusions

In this study, IBD with AFIB was associated with increased in-hospital mortality and morbidity, mean LOS and resource utilization.

SUBMITTER: Rahman EU

PROVIDER: S-EPMC8117082 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

Association of atrial fibrillation with outcomes in patients hospitalized with inflammatory bowel disease: an analysis of the National Inpatient Sample.

Rahman Ebad Ur EU Gayam Vijay V Garlapati Pavani P Patel Neelkumar N Farah Fatima F El-Hamdani Adee A Khan Arfaat A Okhumale Paul I PI Aronow Wilbert S WS El-Hamdani Mehiar M

Archives of medical sciences. Atherosclerotic diseases 20210412

<h4>Introduction</h4>We aimed to determine in-hospital outcomes, length of hospital stay (LOS) and resource utilization in a contemporary cohort of patients with inflammatory bowel disease (IBD) and atrial fibrillation (AFIB).<h4>Material and methods</h4>The National Inpatient Sample database October 2015 to December 2017 was utilized for data analysis using the International Classification of Diseases, Tenth Revision codes to identify the patients with the principal diagnosis of IBD.<h4>Results ...[more]

PMID: 34027213

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Project description:Abstract Background Research has shown mixed results when comparing in‐hospital complications following atrial fibrillation ablation in women compared to men. Objectives To better quantify sex differences and in‐hospital outcomes in atrial fibrillation ablation procedures and identify factors associated with poorer outcomes. Methods We queried the NIS database from 2016 to 2019 for hospitalizations with a primary diagnosis of atrial fibrillation ablation and excluded patients with any other arrhythmias, ICD/pacemaker placement. We assessed demographics, in‐hospital mortality, and complications of women compared to men. Results Admissions for atrial fibrillation were more common in females than males (849 050 vs. 815 665; p < .001). However, females were less likely to receive ablation (1.65% vs. 2.71%, OR: 0.60; 95% confidence interval: 0.57–0.64, p < .001), which persisted after adjusting for cardiomyopathy (adjusted OR: 0.61; 95% confidence interval: 0.58–0.65, p < .001). The primary outcome of in‐hospital mortality was not statistically different in univariate analysis (0.39% vs. 0.36%, OR: 1.09, 95% CI: 0.44–2.72, p = .84), finding that did not change when adjusted for comorbidities (adjusted OR: 0.94, 95% CI: 0.36–2.49). The complication rate in hospitalized patients following ablation was 8.08%. The total unadjusted complication rate was higher for females than males (9.58% vs. 7.09%, p = .001); however, it was not significant when adjusted for risks (adjusted OR: 1.23, 95% CI: 0.99–1.53, p = .06). Conclusion Female sex is not associated with increased complications or death in a real‐world study of catheter ablation when results are adjusted for risks. However, females admitted with atrial fibrillation receive ablation less often than males during hospital admission. Women make up a larger group of admitted atrial fibrillation patients than males. However, women with atrial fibrillation had a 39% lower likelihood of receiving catheter ablation in the hospital when compared to men. In‐hospital mortality was not statistically different between women and men in univariate and multivariate analyses. The total unadjusted complication rate was higher for women than men; however, it was insignificant when adjusted for risks. When controlled for risk factors, female sex was not associated with increased complications or in‐hospital death in a real‐world study.

Project description:BackgroundPatients with atrial fibrillation-flutter (AF) admitted on the weekends were initially reported to have poor outcomes. The primary purpose of this study is to re-evaluate the outcomes for weekend versus weekday AF hospitalization using the 2014 Nationwide Inpatient Sample (NIS).MethodsIncluded hospitalizations were aged above 18 years. The hospitalizations with AF were identified using the international classification of diseases 9 (ICD-9) codes (427.31, 427.32). In-hospital mortality, length of stay (LOS), other co-morbidities, cardioversion procedures, and time to cardioversion were recorded. All analysis was performed using SAS 9.4 statistical software (Cary, North Carolina).ResultsA total of 453,505 hospitalizations with atrial fibrillation and flutter as primary discharge diagnosis were identified. Among the total hospitalizations with a primary diagnosis of AF, 20.3% were admitted on the weekend. Among the weekend hospitalizations, 0.19% died in hospital compared to 0.74% among those admitted during the week. After adjusting for patient characteristics, hospital characteristics and disease severity, the adjusted odds for in-hospital mortality were not significantly different for weekend vs. weekday hospitalizations (OR = 0.91, 95% CI [0.77-1.11]; p = 0.33). The weekend admissions were associated with significantly lower odds of cardioversion procedures (OR = 0.72, 95% CI [0.69-0.76], P < 0.0001), lower cost of hospitalization (USD 8265.8 on weekends vs. USD 8966.5 on the weekdays, P < 0.001), slightly lower rate of anticoagulation (17.09% on the weekends vs. 18.73% on the weekdays. P < 0.0001), and slightly increased time to cardioversion (1.94 days on the weekend vs. 1.73 days on weekdays, P < 0.0005). The mean length of hospital stay (LOS) was statistically not different in both groups: (3.49 days ± 3.70 (SD) in the weekend group vs. 3.47 days ± 3.50 (SD) in the weekday group, P = 0.42).DiscussionThe weekend AF hospitalizations did not have a clinically significant difference in mortality and LOS compared to those admitted on a weekday. However, the use of cardioversion procedures and cost of hospitalization was significantly lower on the weekends.

Dataset Information

Association of atrial fibrillation with outcomes in patients hospitalized with inflammatory bowel disease: an analysis of the National Inpatient Sample.

Introduction

Material and methods

Results

Conclusions

Publications

Association of atrial fibrillation with outcomes in patients hospitalized with inflammatory bowel disease: an analysis of the National Inpatient Sample.

Similar Datasets

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