(170) Mortality Predictors in Inpatients With Atrial Fibrillation and the Impact of Pulmonary Hypertension

Introduction: Pulmonary hypertension (PH) encompasses a diverse group of conditions and remains a significant cause of high morbidity and mortality in healthcare. Similarly, atrial fibrillation (AF) confers higher risk of overall mortality in hospitalized patients. This study aims to investigate the morbidity and mortality profile of patients with combined AF-PH diagnosis and compare it to the trajectories observed in those with PH without AF.

Methods: Using the National Inpatient Sample (NIS) database, International Classification of Diseases, 10th revision (ICD-10) codes were used for the variables of interest. Two cohorts were identified in patients hospitalized from 2017 to 2021: those with AF only (n = 22,944,870) and those with combined AF and PH (n = 2,384,054). Patient characteristics were compared using Pearson Chi-Square analysis for categorical variables and two sample T-tests for continuous variables.

Results: Patients with combined AF and PH had increased risk of inpatient mortality (OR 1.124, 95% CI 1.107-1.14, p < 0.001) and increased length of stay ≥ 7 days (OR 1.607, 95% CI 1.593-1.622, p < 0.001). Other statistically significant comorbidities with increased risk of mortality included myocardial infarction, congestive heart failure, stroke, dementia, moderate/severe liver disease, hemiplegia or paraplegia, renal disease, acquired immunodeficiency syndrome (AIDS), cancer and obstructive sleep apnea (OSA) treated with positive airway pressure (PAP) therapy, and obesity hypoventilation syndrome (OHS). Peripheral vascular disease, rheumatoid disease, peptic ulcer disease, and diabetes mellitus were found to be protective of mortality.

Conclusions: AF and PH interplay to accelerate morbidity and mortality among inpatients. Other comorbidities significantly affect mortality in hospitalized patients with AF. Future research is key in optimizing these conditions amongst patients with AF and PH.