Mehadi Abdulrahim Y, Siraw Bekure B, Patel Parth, Zaher Eli A, Mohamed Ebrahim A, Isha Shahin, Tasamma Abel Tenaw, Tafesse Yordanos T, Gebrecherkos Yonas, Yasmeen Juveriya, Oudih Mouaz, Haroun Mohammed
Department of Internal Medicine, John H. Stroger Hospital of Cook County, Chicago, IL, USA (Abdulrahim Y. Mehadi).
Department of Internal Medicine, Ascension Saint Joseph Hospital, Chicago, IL, USA (Bekure B. Siraw, Parth Patel, Eli A. Zaher, Ebrahim A. Mohamed, Shahin Isha, Yordanos T. Tafesse, Yonas Gebrecherkos, Juveriya Yasmeen, Mouaz Oudih, Mohammed Haroun).
Ann Gastroenterol. 2025 May-Jun;38(3):345-352. doi: 10.20524/aog.2025.0964. Epub 2025 Apr 25.
Endoscopic retrograde cholangiopancreatography (ERCP) is a critical tool in managing hepatobiliary and pancreatic diseases. Atrial fibrillation (AF) has been associated with greater morbidity in patients undergoing ERCP. This study compared in-hospital ERCP outcomes in patients with and without AF.
This retrospective cohort study utilized data from the National Inpatient Sample (2016-2020). Patients who underwent ERCP during hospitalization were included. Patients with AF were matched 1:1 to those without AF, based on demographic and clinical variables. The primary outcome was all-cause in-hospital mortality. Secondary outcomes included procedure-related and non-procedure-related complications, hospitalization cost and length of stay.
The final matched sample consisted of 29,942 patients, with 14,971 in each group (AF and non-AF). Patients with AF demonstrated significantly higher in-hospital mortality compared to those without AF (3.6% vs. 1.9%; odds ratio [OR] 1.87, 95% confidence interval [CI] 1.62-2.17). The AF group had a significantly longer median length of stay (8.1 vs. 6.4 days; β 1.7; 95%CI 1.5-1.8) and incurred higher hospitalization costs ($111,000 vs. $87,255; β $23,745; 95%CI $20,783-26,708). In terms of complications, patients with AF had significantly higher rates of acute kidney injury (OR 1.33, 95%CI 1.27-1.40) and sepsis (OR 1.38, 95%CI 1.30-1.48). However, the rates of procedure-specific complications, including biliary perforation, post-ERCP pancreatitis and post-ERCP cholangitis, were similar between the 2 groups.
Patients with AF undergoing ERCP have higher in-hospital mortality, longer stays, greater costs, and higher rates of acute kidney injury and sepsis, although procedure-specific complication rates remain unaffected.
内镜逆行胰胆管造影术（ERCP）是治疗肝胆和胰腺疾病的关键工具。心房颤动（AF）与接受ERCP的患者更高的发病率相关。本研究比较了有和没有AF的患者的院内ERCP结果。
这项回顾性队列研究利用了国家住院样本（2016 - 2020年）的数据。纳入了住院期间接受ERCP的患者。根据人口统计学和临床变量，将有AF的患者与没有AF的患者按1:1进行匹配。主要结局是全因院内死亡率。次要结局包括与操作相关和与操作无关的并发症、住院费用和住院时间。
最终匹配样本包括29,942名患者，每组各14,971名（AF组和非AF组）。与没有AF的患者相比，有AF的患者院内死亡率显著更高（3.6%对1.9%；优势比[OR]1.87，95%置信区间[CI]1.62 - 2.17）。AF组的中位住院时间显著更长（8.1天对6.4天；β1.7；95%CI 1.5 - 1.8），且住院费用更高（111,000美元对87,255美元；β23,745美元；95%CI 20,783 - 26,708美元）。在并发症方面，有AF的患者急性肾损伤发生率显著更高（OR 1.33，95%CI 1.27 - 1.40）和败血症发生率显著更高（OR 1.38，95%CI 1.30 - 1.48）。然而，两组之间包括胆管穿孔、ERCP术后胰腺炎和ERCP术后胆管炎在内的特定操作并发症发生率相似。
接受ERCP的AF患者院内死亡率更高、住院时间更长、费用更高，急性肾损伤和败血症发生率更高，尽管特定操作并发症发生率不受影响。
