Diabetes and atrial fibrillation in hospitalized patients in the United States

Background Data on the burden of atrial fibrillation (AF) associated with diabetes among hospitalized patients are scarce. We assessed the AF‐related hospitalizations trends in patients with diabetes, and compared AF outcomes in patients with diabetes to those without diabetes. Hypothesis AF‐related...

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Published in:Clinical cardiology (Mahwah, N.J.) Vol. 44; no. 3; pp. 340 - 348
Main Authors: Kumar, Nilay, Echouffo‐Tcheugui, Justin B.
Format: Journal Article
Language:English
Published: New York Wiley Periodicals, Inc 01.03.2021
John Wiley & Sons, Inc
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ISSN:0160-9289, 1932-8737, 1932-8737
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Abstract Background Data on the burden of atrial fibrillation (AF) associated with diabetes among hospitalized patients are scarce. We assessed the AF‐related hospitalizations trends in patients with diabetes, and compared AF outcomes in patients with diabetes to those without diabetes. Hypothesis AF‐related health outcomes differ between patient with diabetes and without diabetes. Methods Using the National Inpatient Sample (NIS) 2004–2014, we studied trends in AF hospitalization rate among diabetic patients, and compared in‐hospital case fatality rate, length of stay (LOS), cost and utilization of rhythm control therapies, and 30‐day readmission rate between patients with and without diabetes. Logistic or Cox regression models were used to assess the differences in AF outcomes by diabetes status. Results Over the study period, there were 4 325 522 AF‐related hospitalizations, of which 1 075 770 (24.9%) had a diagnosis of diabetes. There was a temporal increase in AF hospitalization rate among diabetic patients (10.4 to 14.4 per 1000 hospitalizations among patients with diabetes; +4.4% yearly change, p‐trend < .0001). Among AF patients, those with diabetes had a lower in‐hospital mortality (adjusted odds ratio [aOR]: 0.68; 95% CI: 0.65–0.72) and LOS (aOR: 0.95; 95% CI: 0.94–0.96), but no difference in costs (aOR: 0.95; 95% CI: 0.94–0.96) and a higher 30‐day rate of readmissions compared with no diabetes (aHR 1.05; 95% CI: 1.01–1.08), compared to individuals without diabetes. Conclusion AF and diabetes coexist among hospitalized patients, with rising trends over the last decade. Diabetes is associated with lower rates in‐hospital adverse AF outcomes, but a higher 30‐day readmission risk.
AbstractList Data on the burden of atrial fibrillation (AF) associated with diabetes among hospitalized patients are scarce. We assessed the AF-related hospitalizations trends in patients with diabetes, and compared AF outcomes in patients with diabetes to those without diabetes. AF-related health outcomes differ between patient with diabetes and without diabetes. Using the National Inpatient Sample (NIS) 2004-2014, we studied trends in AF hospitalization rate among diabetic patients, and compared in-hospital case fatality rate, length of stay (LOS), cost and utilization of rhythm control therapies, and 30-day readmission rate between patients with and without diabetes. Logistic or Cox regression models were used to assess the differences in AF outcomes by diabetes status. Over the study period, there were 4 325 522 AF-related hospitalizations, of which 1 075 770 (24.9%) had a diagnosis of diabetes. There was a temporal increase in AF hospitalization rate among diabetic patients (10.4 to 14.4 per 1000 hospitalizations among patients with diabetes; +4.4% yearly change, p-trend < .0001). Among AF patients, those with diabetes had a lower in-hospital mortality (adjusted odds ratio [aOR]: 0.68; 95% CI: 0.65-0.72) and LOS (aOR: 0.95; 95% CI: 0.94-0.96), but no difference in costs (aOR: 0.95; 95% CI: 0.94-0.96) and a higher 30-day rate of readmissions compared with no diabetes (aHR 1.05; 95% CI: 1.01-1.08), compared to individuals without diabetes. AF and diabetes coexist among hospitalized patients, with rising trends over the last decade. Diabetes is associated with lower rates in-hospital adverse AF outcomes, but a higher 30-day readmission risk.
BackgroundData on the burden of atrial fibrillation (AF) associated with diabetes among hospitalized patients are scarce. We assessed the AF‐related hospitalizations trends in patients with diabetes, and compared AF outcomes in patients with diabetes to those without diabetes.HypothesisAF‐related health outcomes differ between patient with diabetes and without diabetes.MethodsUsing the National Inpatient Sample (NIS) 2004–2014, we studied trends in AF hospitalization rate among diabetic patients, and compared in‐hospital case fatality rate, length of stay (LOS), cost and utilization of rhythm control therapies, and 30‐day readmission rate between patients with and without diabetes. Logistic or Cox regression models were used to assess the differences in AF outcomes by diabetes status.ResultsOver the study period, there were 4 325 522 AF‐related hospitalizations, of which 1 075 770 (24.9%) had a diagnosis of diabetes. There was a temporal increase in AF hospitalization rate among diabetic patients (10.4 to 14.4 per 1000 hospitalizations among patients with diabetes; +4.4% yearly change, p‐trend < .0001). Among AF patients, those with diabetes had a lower in‐hospital mortality (adjusted odds ratio [aOR]: 0.68; 95% CI: 0.65–0.72) and LOS (aOR: 0.95; 95% CI: 0.94–0.96), but no difference in costs (aOR: 0.95; 95% CI: 0.94–0.96) and a higher 30‐day rate of readmissions compared with no diabetes (aHR 1.05; 95% CI: 1.01–1.08), compared to individuals without diabetes.ConclusionAF and diabetes coexist among hospitalized patients, with rising trends over the last decade. Diabetes is associated with lower rates in‐hospital adverse AF outcomes, but a higher 30‐day readmission risk.
Data on the burden of atrial fibrillation (AF) associated with diabetes among hospitalized patients are scarce. We assessed the AF-related hospitalizations trends in patients with diabetes, and compared AF outcomes in patients with diabetes to those without diabetes.BACKGROUNDData on the burden of atrial fibrillation (AF) associated with diabetes among hospitalized patients are scarce. We assessed the AF-related hospitalizations trends in patients with diabetes, and compared AF outcomes in patients with diabetes to those without diabetes.AF-related health outcomes differ between patient with diabetes and without diabetes.HYPOTHESISAF-related health outcomes differ between patient with diabetes and without diabetes.Using the National Inpatient Sample (NIS) 2004-2014, we studied trends in AF hospitalization rate among diabetic patients, and compared in-hospital case fatality rate, length of stay (LOS), cost and utilization of rhythm control therapies, and 30-day readmission rate between patients with and without diabetes. Logistic or Cox regression models were used to assess the differences in AF outcomes by diabetes status.METHODSUsing the National Inpatient Sample (NIS) 2004-2014, we studied trends in AF hospitalization rate among diabetic patients, and compared in-hospital case fatality rate, length of stay (LOS), cost and utilization of rhythm control therapies, and 30-day readmission rate between patients with and without diabetes. Logistic or Cox regression models were used to assess the differences in AF outcomes by diabetes status.Over the study period, there were 4 325 522 AF-related hospitalizations, of which 1 075 770 (24.9%) had a diagnosis of diabetes. There was a temporal increase in AF hospitalization rate among diabetic patients (10.4 to 14.4 per 1000 hospitalizations among patients with diabetes; +4.4% yearly change, p-trend < .0001). Among AF patients, those with diabetes had a lower in-hospital mortality (adjusted odds ratio [aOR]: 0.68; 95% CI: 0.65-0.72) and LOS (aOR: 0.95; 95% CI: 0.94-0.96), but no difference in costs (aOR: 0.95; 95% CI: 0.94-0.96) and a higher 30-day rate of readmissions compared with no diabetes (aHR 1.05; 95% CI: 1.01-1.08), compared to individuals without diabetes.RESULTSOver the study period, there were 4 325 522 AF-related hospitalizations, of which 1 075 770 (24.9%) had a diagnosis of diabetes. There was a temporal increase in AF hospitalization rate among diabetic patients (10.4 to 14.4 per 1000 hospitalizations among patients with diabetes; +4.4% yearly change, p-trend < .0001). Among AF patients, those with diabetes had a lower in-hospital mortality (adjusted odds ratio [aOR]: 0.68; 95% CI: 0.65-0.72) and LOS (aOR: 0.95; 95% CI: 0.94-0.96), but no difference in costs (aOR: 0.95; 95% CI: 0.94-0.96) and a higher 30-day rate of readmissions compared with no diabetes (aHR 1.05; 95% CI: 1.01-1.08), compared to individuals without diabetes.AF and diabetes coexist among hospitalized patients, with rising trends over the last decade. Diabetes is associated with lower rates in-hospital adverse AF outcomes, but a higher 30-day readmission risk.CONCLUSIONAF and diabetes coexist among hospitalized patients, with rising trends over the last decade. Diabetes is associated with lower rates in-hospital adverse AF outcomes, but a higher 30-day readmission risk.
Background Data on the burden of atrial fibrillation (AF) associated with diabetes among hospitalized patients are scarce. We assessed the AF‐related hospitalizations trends in patients with diabetes, and compared AF outcomes in patients with diabetes to those without diabetes. Hypothesis AF‐related health outcomes differ between patient with diabetes and without diabetes. Methods Using the National Inpatient Sample (NIS) 2004–2014, we studied trends in AF hospitalization rate among diabetic patients, and compared in‐hospital case fatality rate, length of stay (LOS), cost and utilization of rhythm control therapies, and 30‐day readmission rate between patients with and without diabetes. Logistic or Cox regression models were used to assess the differences in AF outcomes by diabetes status. Results Over the study period, there were 4 325 522 AF‐related hospitalizations, of which 1 075 770 (24.9%) had a diagnosis of diabetes. There was a temporal increase in AF hospitalization rate among diabetic patients (10.4 to 14.4 per 1000 hospitalizations among patients with diabetes; +4.4% yearly change, p‐trend < .0001). Among AF patients, those with diabetes had a lower in‐hospital mortality (adjusted odds ratio [aOR]: 0.68; 95% CI: 0.65–0.72) and LOS (aOR: 0.95; 95% CI: 0.94–0.96), but no difference in costs (aOR: 0.95; 95% CI: 0.94–0.96) and a higher 30‐day rate of readmissions compared with no diabetes (aHR 1.05; 95% CI: 1.01–1.08), compared to individuals without diabetes. Conclusion AF and diabetes coexist among hospitalized patients, with rising trends over the last decade. Diabetes is associated with lower rates in‐hospital adverse AF outcomes, but a higher 30‐day readmission risk.
Author Echouffo‐Tcheugui, Justin B.
Kumar, Nilay
AuthorAffiliation 1 Division of Hospital Medicine, Department of Medicine University of Wisconsin School of Medicine Madison Wisconsin USA
2 Department of Medicine Johns Hopkins University Baltimore Maryland USA
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Issue 3
Keywords atrial fibrillation
diabetes mellitus
trends
Language English
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This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Notes Nilay Kumar and Justin B. Echouffo Tcheugui equally to this study.
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Snippet Background Data on the burden of atrial fibrillation (AF) associated with diabetes among hospitalized patients are scarce. We assessed the AF‐related...
Data on the burden of atrial fibrillation (AF) associated with diabetes among hospitalized patients are scarce. We assessed the AF-related hospitalizations...
BackgroundData on the burden of atrial fibrillation (AF) associated with diabetes among hospitalized patients are scarce. We assessed the AF‐related...
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StartPage 340
SubjectTerms Ablation
Age
Anemia
atrial fibrillation
Atrial Fibrillation - diagnosis
Atrial Fibrillation - epidemiology
Atrial Fibrillation - therapy
Cardiac arrhythmia
Cardioversion
Catheters
Clinical Investigations
Codes
Comorbidity
Diabetes
diabetes mellitus
Diabetes Mellitus - diagnosis
Diabetes Mellitus - epidemiology
Diabetes Mellitus - therapy
Fatalities
Heart failure
Hospitalization
Humans
Hypertension
Length of Stay
Lung diseases
Pacemakers
Patient Readmission
Rehabilitation
Trends
United States - epidemiology
Variables
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Title Diabetes and atrial fibrillation in hospitalized patients in the United States
URI https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fclc.23533
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