Garlapati Pavani, Rahman Ebad Ur, Gayam Vijay, Chobufo Muchi Ditah, Fatima Farah, Khan Arfaat M, Suliman Mohamed, Thompson Ellen A, El-Hamdani Mehiar, Aronow Wilbert S
Interfaith Medical Centre Brooklyn, NY, USA.
St. Mary's Medical Centre, Huntington, WV, USA.
Arch Med Sci Atheroscler Dis. 2020 Sep 14;5:e255-e262. doi: 10.5114/amsad.2020.98949. eCollection 2020.
We aimed to determine the influence of atrial fibrillation (AF) on mortality, morbidity, length of hospital stay, and resource utilisation in patients with oesophageal variceal bleeding (OVB).
The National Inpatient Sample database (2016 and 2017) was used for data analysis using the International Classification of Diseases, Tenth Revision codes to identify patients with the principal diagnosis of OVB and AF. We assessed the all-cause in-hospital mortality, morbidity, predictors of mortality, length of hospital stay (LOS), and total costs between propensity-matched groups of OVB with AF vs. OVB alone.
We identified 80,325 patients with OVB, of whom 4285 had OVB with AF, and 76,040 had OVB only. The in-hospital mortality was higher in OVB with AF (OR = 1.4, 95% CI: 1.09-1.83; < 0.001). OVB with AF had higher odds of sepsis (OR = 1.4, 95% CI: 1.1-1.8; = 0.007), acute kidney injury (OR = 1.2, 95% CI: 1.12-1.32; < 0.001), and mechanical ventilation (OR = 1.2, 95% CI: 1.12-1.32; < 0.001). Advanced age (OR = 1.06, 95% CI: 1.05-1.07; < 0.001), congestive heart failure (OR = 1.7, 95% CI: 1.3-2.3; < 0.001), coronary artery disease (OR = 1.4, 95% CI: 1.03-1.92; = 0.02), and sepsis (OR = 1.3, 95% CI: 1.06-1.70; = 0.01) were identified as predictors of mortality in OVB with AF. Mean LOS (7.5 ±7.4 vs. 6.0 ±7.2, < 0.001) and mean total costs ($25,452 vs. $21,109, < 0.001) were also higher.
In this propensity-matched analysis, OVB with AF was associated with higher odds of in-hospital mortality, sepsis, acute kidney injury, and mechanical ventilation.
我们旨在确定心房颤动（AF）对食管静脉曲张破裂出血（OVB）患者的死亡率、发病率、住院时间和资源利用的影响。
使用国家住院患者样本数据库（2016年和2017年）进行数据分析，采用国际疾病分类第十版编码来识别主要诊断为OVB和AF的患者。我们评估了AF合并OVB与单纯OVB倾向评分匹配组之间的全因住院死亡率、发病率、死亡率预测因素、住院时间（LOS）和总成本。
我们识别出80325例OVB患者，其中4285例为AF合并OVB，76040例仅为OVB。AF合并OVB患者的住院死亡率更高（OR = 1.4，95%CI：1.09 - 1.83；P < 0.001）。AF合并OVB患者发生败血症（OR = 1.4，95%CI：1.1 - 1.8；P = 0.007）、急性肾损伤（OR = 1.2，95%CI：1.12 - 1.32；P < 0.001）和机械通气（OR = 1.2，95%CI：1.12 - 1.32；P < 0.001）的几率更高。高龄（OR = 1.06，95%CI：1.05 - 1.07；P < 0.001）、充血性心力衰竭（OR = 1.7，95%CI：1.3 - 2.3；P < 0.001）、冠状动脉疾病（OR = 1.4，95%CI：1.03 - 1.92；P = 0.02）和败血症（OR = 1.3，95%CI：1.06 - 1.70；P = 0.01）被确定为AF合并OVB患者死亡率的预测因素。平均住院时间（7.5±7.4天对6.0±7.2天，P < 0.001）和平均总成本（25452美元对21109美元，P < 0.001）也更高。
在这项倾向评分匹配分析中，AF合并OVB与更高的住院死亡率、败血症、急性肾损伤和机械通气几率相关。
