Am J Cardiol. 2023 Nov 29:S0002-9149(23)01347-4. doi: 10.1016/j.amjcard.2023.11.050. Online ahead of print.
ABSTRACT
In this study, using a large database we examined the association between atrial fibrillation (AF) among hospitalized patients with pulmonary hypertension (PH) and in-hospital mortality and other adverse hospital outcomes. This study was a retrospective analysis of the US National (Nationwide) Inpatient Sample (NIS) from 2005 to 2014. All hospitalizations for patients diagnosed with primary PH and over the age of 65 were included and then grouped based on the presence AF. Outcomes were in-hospital mortality rate, hospital length of stay, and hospitalization costs. Weighted regression analyses were performed to find the association between AF and outcomes. Among the 5,428,332 hospitalizations with PH, 2,531,075 (46.6%) had concomitant AF. Cox proportional regression analysis showed that among PE patients, all-cause mortality (hazard ratio [HR], 1.35; CI: 1.15-1.55) was significantly higher among AF patients, compared to those without AF. Additionally, PH hospitalizations with AF had higher hospital length of stay (β coefficient, 1.74; 95% CI, 1.58-1.83) and hospitalization cost (β coefficient, 1.33; 95% CI, 1.12-1.42). In patients over 65 years old admitted for PH, the presence of AF was very frequent and worsened the prognosis. In conclusion, to improve patient outcomes and decrease hospital burden, it is important to consider AF during risk stratification for patients with PH to provide timely and prompt interventions. An interdisciplinary approach to treatment should be used to account for the burden of comorbidities in this population.
PMID:38040280 | DOI:10.1016/j.amjcard.2023.11.050