Eltawansy Sherif, Ahmed Faizan, Sharma Grishma, Lajczak Pawel, Obi Ogechukwu, Valand Hardik A, Patel Bhavin, Shehzad Dawood, Abugrin Mohamed, Mubasher Anam, Salman Asjad, Heaton Joseph, Almendral Jesus
Internal Medicine Department, Jersey Shore University Medical Center, Neptune, NJ 08831, USA.
Division of Cardiology, Duke University Hospital, Durham, NC, USA.
J Clin Med Res. 2025 Jun 30;17(6):309-319. doi: 10.14740/jocmr6243. eCollection 2025 Jun.
Chronic obstructive pulmonary disease (COPD) and atrial fibrillation (Afib) are frequently comorbid, with COPD patients exhibiting a higher risk of Afib-related hospitalizations. This study investigated the relationship between COPD and Afib, focusing on 30-day readmission rates and outcomes.
We conducted a retrospective cohort study using the Nationwide Readmissions Database (NRD) from 2016 to 2020. We included adult patients (≥ 18 years) with a primary diagnosis of Afib while excluding those with December discharges to ensure a complete 30-day follow-up. We compared patients with and without COPD, analyzing 30-day readmission rates, length of stay (LOS), hospital costs, in-hospital mortality, and associated factors using multivariable Cox and logistic regression models.
A total of 1,064,982 patients admitted with Afib were included, of which 873,070 had no COPD, and 191,912 had it. COPD patients were older (73.19 vs. 70.82 years), had a shorter LOS (coefficient = -0.05, P = 0.002, 95% confidence interval (CI): -0.08 to -0.02), and had a higher comorbidity burden (Elixhauser comorbidity index: 5.13 vs. 3.43, P < 0.0001). The 30-day readmission rate was significantly higher in the COPD group (16.0% vs. 9.0%, P < 0.001). Logistic regression revealed that COPD increased the odds of readmission (odds ratio: 1.35, 95% CI: 1.32 to 1.39, P < 0.001).
COPD is a significant risk factor for 30-day readmission and in-hospital mortality among Afib patients, underscoring the need for integrated approaches targeting both diseases.
慢性阻塞性肺疾病（COPD）和心房颤动（Afib）常合并存在，COPD患者发生与Afib相关住院的风险更高。本研究调查了COPD与Afib之间的关系，重点关注30天再入院率及转归情况。
我们使用2016年至2020年的全国再入院数据库（NRD）进行了一项回顾性队列研究。纳入成年患者（≥18岁），其主要诊断为Afib，排除12月出院的患者以确保完整的30天随访。我们比较了有和没有COPD的患者，使用多变量Cox和逻辑回归模型分析30天再入院率、住院时间（LOS）、住院费用、院内死亡率及相关因素。
共纳入1,064,982例因Afib入院的患者，其中873,070例无COPD，191,912例有COPD。COPD患者年龄更大（73.19岁对70.82岁），住院时间更短（系数=-0.05，P=0.002，95%置信区间（CI）：-0.08至-0.02），合并症负担更高（埃利克斯豪泽合并症指数：5.13对3.43，P<0.0001）。COPD组的30天再入院率显著更高（16.0%对9.0%，P<0.001）。逻辑回归显示，COPD增加了再入院几率（比值比：1.35，95%CI：1.32至1.39，P<0.001）。
COPD是Afib患者30天再入院和院内死亡的重要危险因素，这凸显了针对这两种疾病采取综合治疗方法的必要性。
