Kichloo Asim, Dahiya Dushyant Singh, Shaka Hafeez, Jamal Shakeel, Khan Muhammad Zia, Wani Farah, Mehboob Asad, Kanjwal Khalil
Department of Internal Medicine, Samaritan Medical Center , Watertown , New York.
Department of Internal Medicine, Central Michigan University College of Medicine , Saginaw , Michigan.
Proc (Bayl Univ Med Cent). 2021 Jul 28;34(6):673-677. doi: 10.1080/08998280.2021.1951071. eCollection 2021.
Systemic inflammation seen in inflammatory bowel disease (IBD) may cause electrophysiological changes in the atria leading to atrial fibrillation (AF). We analyzed data from the National Inpatient Sample for 2018 to identify all adult hospitalizations with a primary diagnosis of IBD, which were further divided based on the presence or absence of AF. The primary outcome was inpatient mortality while the secondary outcomes included inpatient complications, mean length of stay, and mean total hospital charge. We identified 92,055 IBD hospitalizations, of which 3900 (4.2%) had AF and 88,155 (95.8%) served as controls. IBD hospitalizations with AF were older (70.9 vs. 45.0 years, < 0.001) and had a higher association with comorbidities compared to the non-AF cohort. Furthermore, the AF cohort had significantly higher adjusted odds of inpatient mortality (2.05% vs. 0.24%; adjusted odds ratio 2.07; 95% confidence interval [CI] 1.09-3.90; = 0.025), longer length of stay (6.5 vs. 4.9 days; incidence rate ratio 1.23; 95% CI 1.14-1.33; < 0.001), and higher total hospital charge ($14,587 vs. $11,475; incidence rate ratio 1.26; 95% CI 1.15-1.38; < 0.001). Additionally, complications such as acute respiratory failure, pulmonary embolism, and necessity of blood product transfusion were more common for IBD hospitalizations with AF than those without.
炎症性肠病（IBD）中出现的全身炎症可能会导致心房发生电生理变化，进而引发心房颤动（AF）。我们分析了2018年全国住院患者样本数据，以确定所有以IBD为主要诊断的成年住院病例，并根据是否存在AF进一步进行划分。主要结局是住院死亡率，次要结局包括住院并发症、平均住院时间和平均总住院费用。我们确定了92,055例IBD住院病例，其中3900例（4.2%）患有AF，88,155例（95.8%）作为对照。与非AF队列相比，患有AF的IBD住院患者年龄更大（70.9岁对45.0岁，<0.001），且合并症关联更高。此外，AF队列的住院死亡率调整后比值显著更高（2.05%对0.24%；调整后比值比2.07；95%置信区间[CI]1.09 - 3.90；P = 0.025），住院时间更长（6.5天对4.9天；发病率比值1.23；95% CI 1.14 - 1.33；<0.001），总住院费用更高（14,587美元对11,475美元；发病率比值1.26；95% CI 1.15 - 1.38；<0.001）。此外，与无AF的IBD住院患者相比，患有AF的IBD住院患者发生急性呼吸衰竭、肺栓塞和输血必要性等并发症更为常见。
