Nilay Kumar1, Justin B Echouffo-Tcheugui2. 1. Division of Hospital Medicine, Department of Medicine, University of Wisconsin School of Medicine, Madison, Wisconsin, USA. 2. Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Abstract
BACKGROUND: Data on the burden of atrial fibrillation (AF) associated with diabetes among hospitalized patients are scarce. We assessed the AF-related hospitalizations trends in patients with diabetes, and compared AF outcomes in patients with diabetes to those without diabetes. HYPOTHESIS: AF-related health outcomes differ between patient with diabetes and without diabetes. METHODS: Using the National Inpatient Sample (NIS) 2004-2014, we studied trends in AF hospitalization rate among diabetic patients, and compared in-hospital case fatality rate, length of stay (LOS), cost and utilization of rhythm control therapies, and 30-day readmission rate between patients with and without diabetes. Logistic or Cox regression models were used to assess the differences in AF outcomes by diabetes status. RESULTS: Over the study period, there were 4 325 522 AF-related hospitalizations, of which 1 075 770 (24.9%) had a diagnosis of diabetes. There was a temporal increase in AF hospitalization rate among diabetic patients (10.4 to 14.4 per 1000 hospitalizations among patients with diabetes; +4.4% yearly change, p-trend < .0001). Among AF patients, those with diabetes had a lower in-hospital mortality (adjusted odds ratio [aOR]: 0.68; 95% CI: 0.65-0.72) and LOS (aOR: 0.95; 95% CI: 0.94-0.96), but no difference in costs (aOR: 0.95; 95% CI: 0.94-0.96) and a higher 30-day rate of readmissions compared with no diabetes (aHR 1.05; 95% CI: 1.01-1.08), compared to individuals without diabetes. CONCLUSION: AF and diabetes coexist among hospitalized patients, with rising trends over the last decade. Diabetes is associated with lower rates in-hospital adverse AF outcomes, but a higher 30-day readmission risk.
BACKGROUND: Data on the burden of atrial fibrillation (AF) associated with diabetes among hospitalized patients are scarce. We assessed the AF-related hospitalizations trends in patients with diabetes, and compared AF outcomes in patients with diabetes to those without diabetes. HYPOTHESIS: AF-related health outcomes differ between patient with diabetes and without diabetes. METHODS: Using the National Inpatient Sample (NIS) 2004-2014, we studied trends in AF hospitalization rate among diabetic patients, and compared in-hospital case fatality rate, length of stay (LOS), cost and utilization of rhythm control therapies, and 30-day readmission rate between patients with and without diabetes. Logistic or Cox regression models were used to assess the differences in AF outcomes by diabetes status. RESULTS: Over the study period, there were 4 325 522 AF-related hospitalizations, of which 1 075 770 (24.9%) had a diagnosis of diabetes. There was a temporal increase in AF hospitalization rate among diabetic patients (10.4 to 14.4 per 1000 hospitalizations among patients with diabetes; +4.4% yearly change, p-trend < .0001). Among AF patients, those with diabetes had a lower in-hospital mortality (adjusted odds ratio [aOR]: 0.68; 95% CI: 0.65-0.72) and LOS (aOR: 0.95; 95% CI: 0.94-0.96), but no difference in costs (aOR: 0.95; 95% CI: 0.94-0.96) and a higher 30-day rate of readmissions compared with no diabetes (aHR 1.05; 95% CI: 1.01-1.08), compared to individuals without diabetes. CONCLUSION: AF and diabetes coexist among hospitalized patients, with rising trends over the last decade. Diabetes is associated with lower rates in-hospital adverse AF outcomes, but a higher 30-day readmission risk.
Authors: Benjamin A Steinberg; Sunghee Kim; Gregg C Fonarow; Laine Thomas; Jack Ansell; Peter R Kowey; Kenneth W Mahaffey; Bernard J Gersh; Elaine Hylek; Gerald Naccarelli; Alan S Go; James Reiffel; Paul Chang; Eric D Peterson; Jonathan P Piccini Journal: Am Heart J Date: 2014-02-17 Impact factor: 4.749
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Authors: Justin B Echouffo-Tcheugui; Peter Shrader; Laine Thomas; Bernard J Gersh; Peter R Kowey; Kenneth W Mahaffey; Daniel E Singer; Elaine M Hylek; Alan S Go; Eric D Peterson; Jonathan P Piccini; Gregg C Fonarow Journal: J Am Coll Cardiol Date: 2017-09-12 Impact factor: 24.094