Outcomes of hospitalizations with acute respiratory distress syndrome with and without atrial fibrillation - Analyses from the National Inpatient Sample (2004-2014)

Shakeel Jamal, Sardar Hassan Ijaz, Abdul Mannan Khan Minhas, Asim Kichloo, Muhammad Zia Khan, Michael Albosta, Michael Aljadah, Sandeep Banga, Zulfiqar Qutrio Baloch, Hussain Aboud, Abdul Qadir Haji, Ali Sheikh, Khalil Kanjwal

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Acute respiratory distress syndrome (ARDS) is associated with high mortality. Atrial fibrillation (AF) is a common arrhythmia seen in critically ill patients. The impact of AF on the outcomes in patients with ARDS is less understood. In this analysis we attempt to evaluate the association of concurrent AF and various clinical outcomes in patients with ARDS. Methods: We conducted a retrospective analysis of adult discharges from the National Inpatient Sample (NIS) between 2004 and 2014. International Classification of Disease codes were used to identify those with ARDS and AF. Results: We found 1,200,737 hospitalizations with ARDS, out of which 238,455 had concomitant diagnosis of AF. Hospitalizations with AF had higher prevalence of comorbidities including chronic pulmonary disease, diabetes mellitus, hypertension, obesity, congestive heart failure and renal failure. On adjusted analysis, AF was associated with increased odds of acute myocardial infarction, cardiogenic shock, pressor use, acute kidney injury, permanent pacemaker implantation, cardiac arrest, mechanical circulatory support use and higher length of stay and inflation-adjusted cost in hospitalizations with ARDS. However, there was no significant difference in adjusted all-cause mortality in ARDS with and without AF (25.42% vs 20.23%, p=0.53). Conclusions: AF is associated with worse clinical outcomes, higher length of stay and cost in ARDS hospitalizations as compared to those without AF.

Original languageEnglish
Pages (from-to)289-295
Number of pages7
JournalAmerican Journal of the Medical Sciences
Volume364
Issue number3
DOIs
StatePublished - Sep 2022

Keywords

  • Acute Respiratory Distress Syndrome
  • Arrhythmia
  • Atrial Fibrillation
  • Critical Care
  • Electrophysiology

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