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Impact of Pulmonary Hypertension in Outcomes of Atrial Fibrillation Hospitalizations FREE TO VIEW

Awani Deshmukh; Shilpkumar Arora, MPH; Amina Saqib; Nileshkumar Patel; Mohammad Siddiqui; Hakan Paydak; Manish Joshi
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University of Arkansas for Medical Sciences, Little Rock, AR

Chest. 2014;146(4_MeetingAbstracts):839A. doi:10.1378/chest.1993963
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SESSION TITLE: DVT/PE/Pulmonary Hypertension Posters III

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Atrial fibrillation (AF) represents a significant healthcare burden. Literature reporting the incidence and outcomes of AF in pulmonary hypertension (PH) is limited. We sought to examine the frequency and outcomes of AF in patients with PH.

METHODS: Using the Nationwide Inpatient Sample 2000-2010, patients aged 18 or more discharged with primary diagnosis of atrial fibrillation (AF), were identified. The diagnosis of pulmonary hypertension was identified through appropriate validated ICD-9 codes. Wilcoxon signed-rank test was performed to quantify differences in length of stay (LOS), cost of care and inhospital mortality in patients with AF and PH vs. AF only. The analysis was adjusted for age, demographics and other relevant co-morbid conditions.

RESULTS: We identified 804034 AF related hospitalizations. There has been a significant increase in AF hospitalizations associated with PH. (0.7% in year 2000 to 6.2 % in year 2010) . Overall the AF related hospitalizations associated with PH had longer LOS ( median 4 days vs. 3 days , p < 0.001 ) , higher cost of care ( $ 6622 vs. $ 5070 , p < 0.011 ) and higher inhospital mortality ( 1.19 % vs.1.03 % , p<0.001 )

CONCLUSIONS: Using nationally representative data, this observational study showed that AF hospitalizations are increasing in patients with PH. PH is an independent risk factor for inhospital mortality and health care resource utilization. Prospective trials are needed to evaluate causal relationships and analyze clinical outcomes.

CLINICAL IMPLICATIONS: Diagnosis of PH is showing an increasing frequency in patients with AF . PH independently predicts a worse outcome in this group of patients.

DISCLOSURE: The following authors have nothing to disclose: Awani Deshmukh, Shilpkumar Arora, Amina Saqib, Nileshkumar Patel, Mohammad Siddiqui, Hakan Paydak, Manish Joshi

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