Key result
HIV infection linked to ~80% higher inpatient mortality in hospitalized AF patients.
Why the study?
The prevalence of age-related cardiovascular disease and arrhythmias is expected to increase among the HIV-positive population, but trends and inpatient outcomes in patients with HIV and atrial fibrillation were not well characterized.
Does HIV infection worsen in-hospital outcomes in patients with atrial fibrillation?
Observational (n=38,284,082)
Yes
Does HIV infection worsen in-hospital outcomes in patients with atrial fibrillation?
Absolute Event Rate: 9.2% vs 5.1%
HIV infection in patients hospitalized with atrial fibrillation is associated with significantly higher inpatient mortality, longer hospital stays, and increased healthcare costs despite a younger median age.
Background The development of highly active anti-retroviral therapy (HAART) has markedly prolonged the life expectancy of individuals with human immunodeficiency virus (HIV). The prevalence of age-related cardiovascular disease (CVD) and arrhythmias is therefore expected to increase among the HIV-positive population.Objectives We aimed to assess the trends in prevalence, and inpatient outcomes among patients with HIV and atrial fibrillation (AF).Methods Using ICD-9-CM coding, we identified 38,252,858 HIV-negative and 31,224 HIV-positive encounters with AF from the National Inpatient Sample (NIS) database from January 2005 to September 2015. Trends in prevalence of HIV in AF patients, length and cost of hospital stay, and inpatient mortality, were determined. t-Test was used for continuous variables and Chi-square test for categorical variables. Final multivariable logistic regression models were constructed to determine predictors of outcomes.Results Among the 31,224 HIV-positive encounters, 78.6% were males. The median age was 56 years for HIV-positive patients and 78 years for HIV-negative patients. Black patients were markedly overrepresented among HIV-positive as compared to HIV-negative hospitalisations (48.6 vs. 7.6%). The prevalence of alcohol and drug use, smoking, chronic kidney disease, chronic liver disease, and cancer was higher among HIV-positive as compared to HIV-negative patients. The prevalence of HIV among the AF hospitalisations increased from 2005 to 2015. As compared to HIV-negative patients, individuals with HIV demonstrated increased inpatient mortality (9.2 vs. 5.1%), longer length of stay (6 [3–11] vs. 4 [2–7] days), and increased cost of treatment ($12,464 vs. $8606).Conclusion The prevalence of HIV among patients with AF increased between 2005 and 2015. As compared to HIV-negative individuals with AF, a diagnosis of HIV was associated with increased inpatient mortality, length of stay, and cost of care. Future research on the underlying mechanisms of these findings is warranted to inform the treatment of AF in patients with HIV.
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Antwi‐Amoabeng et al. (2022) conducted an observational in Atrial fibrillation (n=38,284,082). HIV infection vs. HIV-negative was evaluated on Inpatient mortality. Among patients hospitalized with atrial fibrillation, HIV infection was associated with increased inpatient mortality (9.2% vs. 5.1%) compared to HIV-negative patients.
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