Key result
Incident atrial fibrillation diagnosed during hospital admission for community-acquired pneumonia was associated with significantly higher in-hospital mortality compared to patients without atrial fibrillation.
Why the study?
The influence of prevalent versus incident AF on in-hospital mortality in women and men admitted for CAP required investigation.
Does atrial fibrillation (prevalent or incident) increase in-hospital mortality in adults admitted for community-acquired pneumonia?
Observational (n=519,750)
Yes
Does atrial fibrillation (prevalent or incident) increase in-hospital mortality in adults admitted for community-acquired pneumonia?
Incident, but not prevalent, atrial fibrillation is independently associated with increased in-hospital mortality in patients admitted for community-acquired pneumonia.
Incident AF may identify higher-risk pneumonia patients; leaves open whether it is causal or warrants targeted intervention.
We aimed to analyze the influence of atrial fibrillation (AF) prior to hospital admission ("prevalent") and AF diagnosed during hospital admission ("incident") on in-hospital mortality (IHM) in women and men admitted for community-acquired pneumonia (CAP) in Spain (2016-2019). We used the Spanish Register of Specialized Care-Basic Minimum Database. We analyzed 519,750 cases of CAP in people ≥ 18 years (213,631 women (41.1%)), out of which people with prevalent AF represented 23.75% (N = 123,440), whereas people with incident AF constituted 0.60% (N = 3154). Versus no AF, crude IHM was significantly higher for prevalent AF (15.24% vs. 11.40%, p < 0.001) and for incident AF (23.84% vs. 12.24%, p < 0.001). After propensity score marching, IHM in women and men with prevalent AF neared IHM in women and men with no AF (15.72% vs. 15.52%, p = 0.425; and 14.90% vs. 14.99%, p = 0.631, respectively), but IHM in women and men with incident AF was higher than IHM in women and men with no AF (24.37% vs. 13.36%, p < 0.001; and 23.94% vs. 14.04%, p < 0.001, respectively). Male sex was associated with a higher IHM in people with prevalent AF (OR 1.06; 95% CI 1.02-1-10), but not in people with incident AF (OR 0.93; 95% CI 0.77-1-13). AF diagnosed during hospital admission was associated with a higher IHM, irrespectively of sex.
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de-Miguel-Yanes et al. (2022) conducted an observational in Community-acquired pneumonia (n=519,750). Incident atrial fibrillation during hospital admission vs. No atrial fibrillation was evaluated on In-hospital mortality (p=<0.001). Incident atrial fibrillation diagnosed during hospital admission for community-acquired pneumonia was associated with significantly higher in-hospital mortality compared to patients without atrial fibrillation.
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