Key result
Diabetes in hospitalized AF is linked to ~32% lower in-hospital mortality but higher 30-day readmission.
Why the study?
Data on the burden of AF associated with diabetes among hospitalized patients are scarce.
Does diabetes affect in-hospital outcomes and 30-day readmission rates in patients hospitalized for atrial fibrillation?
Observational (n=4,325,522)
Yes
Does diabetes affect in-hospital outcomes and 30-day readmission rates in patients hospitalized for atrial fibrillation?
Effect estimate: aOR 0.68 (95% CI 0.65-0.72)
In patients hospitalized for atrial fibrillation, comorbid diabetes is associated with lower in-hospital mortality but a higher risk of 30-day readmission.
Diabetes was associated with lower AF hospitalization mortality but higher readmission; leaves open confounding versus causal effects pending prospective validation.
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.
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Kumar et al. (2021) conducted an observational in Atrial fibrillation (n=4,325,522). Diabetes vs. No diabetes was evaluated on In-hospital mortality (aOR 0.68, 95% CI 0.65-0.72). Diabetes in hospitalized patients with atrial fibrillation was associated with lower in-hospital mortality (aOR 0.68; 95% CI 0.65-0.72) but a higher 30-day readmission rate (aHR 1.05).
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