ISSN: 2451-0629
Archives of Medical Science - Atherosclerotic Diseases
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Official journal of the International Lipid Expert Panel (ILEP)
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1/2020
vol. 5
 
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abstract:
Clinical research

Outcomes of oesophageal variceal bleeding among patients with atrial fibrillation: a propensity-matched analysis of a nationwide inpatient sample

Pavani Garlapati
1
,
Ebad Ur Rahman
2
,
Vijay Gayam
1
,
Muchi Ditah Chobufo
1
,
Farah Fatima
3
,
Arfaat M. Khan
4
,
Mohamed Suliman
5
,
Ellen A. Thompson
5
,
Mehiar El-Hamdani
5
,
Wilbert S. Aronow
6

1.
Interfaith Medical Centre Brooklyn, NY, USA
2.
St. Mary’s Medical Centre, Huntington, WV, USA
3.
Deccan College of Medical Sciences, Hyderabad, India
4.
Henry Ford Health System, Detroit, MI, USA
5.
Marshall University, Huntington, WV, USA
6.
Westchester Medical Centre and New York Medical College, Valhalla, NY, USA
Arch Med Sci Atheroscler Dis 2020; 5: e255–e262
Online publish date: 2020/09/14
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Introduction
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).

Material and methods
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.

Results
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; p < 0.001). OVB with AF had higher odds of sepsis (OR = 1.4, 95% CI: 1.1–1.8; p = 0.007), acute kidney injury (OR = 1.2, 95% CI: 1.12–1.32; p < 0.001), and mechanical ventilation (OR = 1.2, 95% CI: 1.12–1.32; p < 0.001). Advanced age (OR = 1.06, 95% CI: 1.05–1.07; p < 0.001), congestive heart failure (OR = 1.7, 95% CI: 1.3–2.3; p < 0.001), coronary artery disease (OR = 1.4, 95% CI: 1.03–1.92; p = 0.02), and sepsis (OR = 1.3, 95% CI: 1.06–1.70; p = 0.01) were identified as predictors of mortality in OVB with AF. Mean LOS (7.5 ±7.4 vs. 6.0 ±7.2, p < 0.001) and mean total costs ($25,452 vs. $21,109, p < 0.001) were also higher.

Conclusions
In this propensity-matched analysis, OVB with AF was associated with higher odds of in-hospital mortality, sepsis, acute kidney injury, and mechanical ventilation.

keywords:

oesophageal variceal bleeding, atrial fibrillation, National Inpatient Sample, propensity-matched outcomes

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