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Better Strategies Needed to Manage Patients Hospitalized with COPD, Atrial Fibrillation
The prevalence of atrial fibrillation increased in the United States from 2003 to 2014 among patients hospitalized with end-stage chronic obstructive pulmonary disease (COPD), according to results of a retrospective analysis.
“Better management strategies for patients with end-stage COPD comorbid with [atrial fibrillation] are needed, especially in elderly individuals,” Xiaochun Xiao, MPH, researcher in the department of health statistic at Second Military Medical University in Shanghai, and colleagues wrote in Chest.
Researchers evaluated data from 1,345,270 patients included in the 2003 to 2014 Nationwide Inpatient Sample. Xiao and colleagues assessed the prevalence of atrial fibrillation (AF) in patients with end-stage COPD on home oxygen admitted for COPD exacerbation. Several models were used to evaluate the association of AF with clinical factors, cost, length of hospital stay and hospital outcomes.
Of all patients admitted for COPD exacerbation, more than 18 percent had AF.
The primary outcome found is that temporal trend of AF prevalence increased substantially from about 13 percent in 2003 to more than 21 percent in 2014.
Patients with AF were more likely to be older (75 vs. 69 years), white (80 percent vs. 74 percent) and male (59 percent vs. 50 percent) compared with those without atrial fibrillation.
Comorbidities associated with increased prevalence of AF included congestive heart failure, valvulopathy, pulmonary circulation, chronic blood anemia and coagulopathy. AF was associated with increased healthcare costs and hospital length-of-stay, and was a risk indicator of stroke, in-hospital death, sepsis, acute respiratory failure and acute kidney injury.
“Our study represents the most current assessment of temporal trends and characteristics of atrial fibrillation among hospital encounters in the United States with end-stage COPD on home oxygen who were hospitalized for COPD exacerbation,” researchers wrote.
