Abdullah Sayied Abdullah1, George Eigbire2, Mohamed Ali3, Mohanad Awadalla4, Abdul Wahab5, Hisham Ibrahim6, Amr Salama5, Richard Alweis5,7,8. 1. Sands-Constellation Heart Institute-Rochester General Hospital, Rochester, NY. 2. Department of Cardiology - Louisiana State University, New Orleans, LA. 3. Department of Cardiology - Royal Victoria Hospital, Blackpool, UK. 4. Department of Medicine - University of Massachusetts Memorial Medical Center, Worcester, MA. 5. Department of Medicine - Unity Hospital - Rochester Regional Health, Rochester, NY. 6. Department of Cardiology - University of Iowa, Iowa City, IA. 7. Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY. 8. School of Health Sciences, Rochester Institute of Technology, Rochester, NY.
Abstract
INTRODUCTION: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of hospitalization and is associated with an increased incidence of atrial fibrillation (AF). The impact of AF on in-hospital outcomes, including mortality, in patients hospitalized for COPD exacerbation is not well elucidated. METHODS: We used the National Inpatient Sample database to examine discharges with the primary diagnosis of COPD exacerbation and compared mortality, length of stay and costs in patients with AF compared to those without AF. The study adjusted the outcomes for known cardiovascular risk factors and confounders using logistic regression and propensity score matching analysis. RESULTS: Among 1,377,795 discharges with COPD exacerbation, 16.6% had AF. Patients with AF were older and had more comorbidities. Mortality was higher (2.4%) in the AF group than in the no AF group (1%), p <0.001. After adjustment to age, sex and confounders, AF remained an independent predictor for mortality, OR:1.44 (95% CI 133 - 1.56, p <0.001), prolonged length of stay, OR:1.63 (95% CI 1.57 - 1.69, p <0.001) and increased cost, OR: 1.45 (95% CI: 1.40 - 1.49, p <0.001). CONCLUSIONS: among patients with COPD exacerbation, AF was associated with increased mortality and higher resource utilization.
INTRODUCTION: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of hospitalization and is associated with an increased incidence of atrial fibrillation (AF). The impact of AF on in-hospital outcomes, including mortality, in patients hospitalized for COPD exacerbation is not well elucidated. METHODS: We used the National Inpatient Sample database to examine discharges with the primary diagnosis of COPD exacerbation and compared mortality, length of stay and costs in patients with AF compared to those without AF. The study adjusted the outcomes for known cardiovascular risk factors and confounders using logistic regression and propensity score matching analysis. RESULTS: Among 1,377,795 discharges with COPD exacerbation, 16.6% had AF. Patients with AF were older and had more comorbidities. Mortality was higher (2.4%) in the AF group than in the no AF group (1%), p <0.001. After adjustment to age, sex and confounders, AF remained an independent predictor for mortality, OR:1.44 (95% CI 133 - 1.56, p <0.001), prolonged length of stay, OR:1.63 (95% CI 1.57 - 1.69, p <0.001) and increased cost, OR: 1.45 (95% CI: 1.40 - 1.49, p <0.001). CONCLUSIONS: among patients with COPD exacerbation, AF was associated with increased mortality and higher resource utilization.
Authors: Michael T Durheim; DaJuanicia N Holmes; Rosalia G Blanco; Larry A Allen; Paul S Chan; James V Freeman; Gregg C Fonarow; Alan S Go; Elaine M Hylek; Kenneth W Mahaffey; Sean D Pokorney; James A Reiffel; Daniel E Singer; Eric D Peterson; Jonathan P Piccini Journal: Heart Date: 2018-06-06 Impact factor: 5.994
Authors: Suellen M Curkendall; Cynthia DeLuise; Judith K Jones; Stephan Lanes; Mary Rose Stang; Earl Goehring; Dewei She Journal: Ann Epidemiol Date: 2005-07-21 Impact factor: 3.797
Authors: Miguel Divo; Claudia Cote; Juan P de Torres; Ciro Casanova; Jose M Marin; Victor Pinto-Plata; Javier Zulueta; Carlos Cabrera; Jorge Zagaceta; Gary Hunninghake; Bartolome Celli Journal: Am J Respir Crit Care Med Date: 2012-05-03 Impact factor: 21.405
Authors: Jeff S Healey; Jonas Oldgren; Michael Ezekowitz; Jun Zhu; Prem Pais; Jia Wang; Patrick Commerford; Petr Jansky; Alvaro Avezum; Alben Sigamani; Albertino Damasceno; Paul Reilly; Alex Grinvalds; Juliet Nakamya; Akinyemi Aje; Wael Almahmeed; Andrew Moriarty; Lars Wallentin; Salim Yusuf; Stuart J Connolly Journal: Lancet Date: 2016-08-08 Impact factor: 79.321
Authors: Abdullah Abdullah; George Eigbire; Amr Salama; Abdul Wahab; Ninad Nadkarni; Richard Alweis Journal: Am J Cardiol Date: 2018-06-20 Impact factor: 2.778