Ahmed Subahi1, Emmanuel Akintoye1, Ahmed S Yassin1, Hossam Abubakar1, Oluwole Adegbala2, Tushar Mishra1, Mohamed Abdelrahman3, Mohamed Shokr4, Luis Afonso4. 1. Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, Michigan. 2. Department of Internal Medicine, Englewood Hospital and Medical Center, Seton Hall University-Hackensack Meridian School of Medicine, Englewood, New Jersey. 3. Department of Internal Medicine, Metro Health System, Cleveland, Ohio. 4. Division of Cardiology, Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, Michigan.
Abstract
BACKGROUND: Atrial fibrillation (AF) is associated with increased all-cause mortality in the general population. However, the impact of AF on the in-hospital outcomes of acute myocarditis (AM) patients is not well characterized. METHODS: Patients (age ≥ 18 years) with a primary diagnosis of AM in the National Inpatient Sample from 2007 to 2014 were included, using the ICD-9-CM diagnostic codes. We compared the in-hospital outcomes between the AF group and propensity score-matched control group without AF. RESULTS: AF was reported in 602 (9%) of the AM patients. Compared to those without AF, AM patients with AF experienced higher in-hospital mortality (odds ratio [OR] 1.7, 95% confidence interval [CI] 1.1-2.7, P = 0.02). AF was associated with higher risk of cardiogenic shock (OR 1.9, 95% CI 1.3-2.8, P < 0.001), cardiac tamponade (OR 5.6, 95% CI 1.2-25.3, P = 0.002) and acute kidney injury (OR 1.6, 95% CI 1.1-2.1, P = 0.02). Furthermore, patients with AF were more likely to have non-routine hospital discharge (31.6% vs 38.4% P = 0.02), longer length of stay and higher cost of hospitalization. CONCLUSIONS: AF was associated with increased risk of in-hospital mortality and complications in patients admitted to the hospital with acute myocarditis.
BACKGROUND:Atrial fibrillation (AF) is associated with increased all-cause mortality in the general population. However, the impact of AF on the in-hospital outcomes of acute myocarditis (AM) patients is not well characterized. METHODS:Patients (age ≥ 18 years) with a primary diagnosis of AM in the National Inpatient Sample from 2007 to 2014 were included, using the ICD-9-CM diagnostic codes. We compared the in-hospital outcomes between the AF group and propensity score-matched control group without AF. RESULTS:AF was reported in 602 (9%) of the AM patients. Compared to those without AF, AM patients with AF experienced higher in-hospital mortality (odds ratio [OR] 1.7, 95% confidence interval [CI] 1.1-2.7, P = 0.02). AF was associated with higher risk of cardiogenic shock (OR 1.9, 95% CI 1.3-2.8, P < 0.001), cardiac tamponade (OR 5.6, 95% CI 1.2-25.3, P = 0.002) and acute kidney injury (OR 1.6, 95% CI 1.1-2.1, P = 0.02). Furthermore, patients with AF were more likely to have non-routine hospital discharge (31.6% vs 38.4% P = 0.02), longer length of stay and higher cost of hospitalization. CONCLUSIONS:AF was associated with increased risk of in-hospital mortality and complications in patients admitted to the hospital with acute myocarditis.
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