Arrhythmias in patients with in-hospital alcohol withdrawal are associated with increased mortality: Insights from 1.5 million hospitalizations for alcohol withdrawal syndrome

BACKGROUND: Atrial arrhythmias are commonly noted in patients with alcohol withdrawal syndrome (AWS), requiring inpatient admission. OBJECTIVE: The burden of arrhythmias and the association with in-hospital outcomes are incompletely defined in patients hospitalized with AWS. METHODS: The nationwide...

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Detalles Bibliográficos
Autores principales: Thakkar, Samarthkumar, Patel, Harsh P., Boppana, Leela Krishna Teja, Faisaluddin, Mohammad, Rai, Devesh, Sheth, Aakash R., Kumar, Ashish, Kutom, Fadee, Zahid, Salman, Baibhav, Bipul, Dani, Sourbha S., Rao, Mohan, DeSimone, Christopher V., Deshmukh, Abhishek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Clinical
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8703122/
https://www.ncbi.nlm.nih.gov/pubmed/34988506
http://dx.doi.org/10.1016/j.hroo.2021.09.014
Descripción
Sumario:BACKGROUND: Atrial arrhythmias are commonly noted in patients with alcohol withdrawal syndrome (AWS), requiring inpatient admission. OBJECTIVE: The burden of arrhythmias and the association with in-hospital outcomes are incompletely defined in patients hospitalized with AWS. METHODS: The nationwide inpatient sample database was accessed from September 2015 to December 2018 to identify hospitalizations for AWS. We studied a cohort of patients with arrhythmias noted during hospitalization using the appropriate International Classification of Diseases, Tenth Revision billing codes. We compared patient characteristics, outcomes, and hospitalization costs between alcohol withdrawal hospitalizations with and without documented arrhythmias. Propensity score matching (PSM) and multivariate regression were performed to control confounders and develop odds ratios (OR), respectively. RESULTS: Among 1,511,155 hospitalization with AWS, 146,825 (9.72%) had concurrent arrhythmias. After PSM, we identified 135,540 cases in each group. Hospitalizations with AWS and concurrent arrhythmias had higher in-hospital mortality (4.19% vs 1.95%, OR 1.76, confidence interval [CI] 1.67–1.85, P < .0001). The most common arrhythmia was atrial fibrillation (66.7%). Arrhythmias in AWS were also associated with poorer in-hospital outcomes, including a higher risk of acute heart failure (8.40% vs 4.58%, OR 1.97, CI 1.90–2.05, P < .0001), acute kidney injury (21.32% vs 15.27%, OR 1.39, CI 1.36–1.43, P < .0001), and acute respiratory failure (9.19% vs 5.49%, OR 1.70, CI 1.64–1.76, P < .0001) requiring intubation. The length of hospital stay (6 days vs 4 days P < .0001) and cost of hospital care ($12,615 [$6683–$27,330] vs $7860 [$4482–$15,868], P < .0001) were higher in AWS with arrhythmias. CONCLUSION: Arrhythmia in AWS is associated with higher in-hospital mortality and poorer in-hospital outcomes.

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