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Int J Cardiol Heart Vasc . Effects of atrial fibrillation on outcomes of influenza hospitalization

tetano

Editor, Senior Moderator
Int J Cardiol Heart Vasc


. 2022 Aug 17;42:101106.
doi: 10.1016/j.ijcha.2022.101106. eCollection 2022 Oct.
Effects of atrial fibrillation on outcomes of influenza hospitalization


Alexander Bolton[SUP] 1 [/SUP], Harshith Thyagaturu[SUP] 2 [/SUP], Muddasir Ashraf[SUP] 1 [/SUP], Ryan Carnahan[SUP] 1 [/SUP], Denice Hodgson-Zingman[SUP] 3 [/SUP]



Affiliations

Abstract

Background: There is little information available on AF and its association with outcomes in adult influenza hospitalizations.
Methods: The National Inpatient Sample was queried from years 2009-2018 to create a cohort of discharges containing an influenza diagnosis. AF was the primary exposure. Univariate and multivariate regression analysis was used to describe the association of AF with clinical and healthcare-resource outcomes. Finally, a doubly-robust analysis using average treatment effect on the treated (ATT) propensity score weighting was performed to verify the results of traditional regression analysis.
Results: After adjustment, the presence of AF during influenza hospitalization was associated with higher odds of in-hospital mortality (aOR 1.56, 95 % CI 1.49 - 1.65), acute respiratory failure (aOR 1.22, 95 % CI 1.19 - 1.25), acute respiratory failure with mechanical ventilation (aOR 1.37, 95 % CI 1.32 - 1.41), acute kidney injury (aOR 1.09, 95 % CI 1.06 - 1.12), acute kidney injury requiring dialysis (aOR 1.61, 95 % CI 1.46 - 1.78) and cardiogenic shock (aOR 1.90, 95 % CI 1.65 - 2.20, all p-values < 0.0001). These findings were validated in our propensity score analysis using ATT weights. The presence of AF was also associated with higher total charges and costs of hospitalization, as well as a significantly longer length of stay (all p-values < 0.0001).
Conclusion: AF is a cardiovascular comorbidity associated with worse clinical and healthcare resource outcomes in influenza requiring hospitalization. Its presence should be used to identify patients with influenza at risk of worse prognosis.

Keywords: Atrial Fibrillation; Hospital Mortality; Hospitalization; Influenza.
 
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