Impact of Chronic Kidney Disease on Outcomes in Patients Admitted to the Hospital for Paroxysmal Atrial Fibrillation: A National Inpatient Sample Database Analysis

Abstract

Atrial fibrillation (AF) and chronic kidney disease (CKD) are interrelated in various ways. They share many of the same risk factors and they are known risk factors for each other. AF prevalence ranges between 15% and 20% in advanced stages of CKD, while CKD is associated with increased cardiovascular risk and all-cause mortality, affecting 40–50% of patients with AF [1-4]. We aim to study the impact of CKD and Hemodialysis on the mortality, length of stay and total cost of hospitalization in patients admitted with the primary diagnosis of paroxysmal atrial fibrillation.
Methods: It was a retrospective cohort study using the 2018 National Inpatient Sample to include adult patients with CKD, admitted to the hospital with the primary diagnosis of paroxysmal atrial fibrillation (ICD-10 code: I48.0). Outcomes were mortality, length of stay and total cost of hospitalization. Patients on hemodialysis were studied as a separate group.
Results: We found a total of 29,005 eligible cases with CKD who were admitted with the primary diagnosis of paroxysmal AF and 3735 (12.9%) were receiving hemodialysis. The mean age was 74.64 years and 53.3% were females. 76.25% were White, 12.78% were African-American, 6.48% were Hispanic, 2.17% were Asian or pacific islander and 0.51% were Native American. 100% had a Charlson comorbidity index score of 2 or higher, while 81.36% had a median household income of less than $74.000 a year