Key result
Among hospitalized patients with end-stage liver disease, atrial fibrillation was associated with significantly higher in-hospital mortality (OR 1.40; 95% CI 1.35-1.45).
Why the study?
The study aimed to investigate temporal trends, patient characteristics, and outcomes of AF in hospitalized ESLD patients across the United States.
Does the presence of atrial fibrillation increase in-hospital mortality, length of stay, and cost in hospitalized patients with end-stage liver disease?
Observational (n=639,345)
Yes
Does the presence of atrial fibrillation increase in-hospital mortality, length of stay, and cost in hospitalized patients with end-stage liver disease?
In hospitalized patients with end-stage liver disease, the presence of atrial fibrillation is increasing in prevalence and is associated with significantly higher in-hospital mortality, length of stay, and costs.
BACKGROUND & AIMS: End-stage liver disease (ESLD) happens due to the development and progression of chronic liver disease. This study aims to investigate the temporal trend, patient characteristics and outcomes of atrial fibrillation (AF) in hospitalized ESLD patients across the United States. METHODS: Nationwide Inpatient Sample from 2003 to 2014 was utilized to retrospectively study the weighted prevalence of AF in hospitalized ESLD patients. Multivariable regression models were used to assess the association between AF with clinical factors, in-hospital mortality, length of stay (LOS) and cost. RESULTS: 639 345 hospitalizations associated with ESLD were identified, of which 47 710 (7.48%) were diagnosed with AF. The prevalence of AF increased from 5.73% in 2003 to 9.75% in 2014 in ESLD and varied by age, race, income, insurance type and hospital characteristics. Factors associated with AF included advancing age, male, white race, high income and urban teaching hospital. AF presence was associated with significant higher in-hospital mortality (odds ratio, 1.40; 95% confidence interval, 1.35-1.45), 21% longer LOS and 22% higher cost. In addition, a significant decreasing trend in in-hospital mortality was observed (from 16.70% to 10.63% in patients with AF and from 10.74% to 7.50% in patients without AF). CONCLUSIONS: The prevalence of AF in hospitalized ESLD patients has continued to increase from 2003 through 2014. AF is associated with poor prognosis and higher health resource utilization. Innovative anticoagulation strategies through improved collaboration between cardiologists and hepatologists are required for better management of hospitalized ESLD patients comorbid with AF.
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Han et al. (2019) conducted an observational in End-stage liver disease (n=639,345). Atrial fibrillation vs. No atrial fibrillation was evaluated on In-hospital mortality (OR 1.40, 95% CI 1.35-1.45). Among hospitalized patients with end-stage liver disease, atrial fibrillation was associated with significantly higher in-hospital mortality (OR 1.40; 95% CI 1.35-1.45).
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