Abstract
Introduction
Influenza infection could cause systemic inflammatory response and lead to increase sympathetic tone. The association and impact of atrial fibrillation (AF) on Influenza has not been well studied.
Purpose
To evaluate the association of atrial fibrillation with mortality and resource utilization in influenza hospitalizations.
Methods
We queried 2018 National Inpatient Sample (NIS) database to identify influenza and AF hospitalizations using appropriate ICD-10 codes. Influenza with AF group was compared to influenza without AF. Chi-square test and linear regression were used for categorical and continuous variables, respectively. Multivariate logistic regression was used to adjust for potential hospital and patient confounders (age, sex, race, diabetes, systolic heart failure, chronic kidney disease, obesity, charlson co-morbidity index, hospital location, teaching status, bed size and income status). Discharge weights provided in the database was used to calculate the national estimates. STATA 16.1 was used to perform all statistical analysis.
Results
345,419 weighted influenza hospitalizations were identified. Of which, 78,824 (22.8%) of them had atrial fibrillation. Influenza patients with AF were older (mean age: 77 vs. 65 yrs; p<0.01) but had similar number of female (52% vs 48%; p<0.01) compared to influenza patients without AF. After adjusting for potential hospital and patient level confounders, we observed statistically significant increase in mortality [Adjusted Odds Ratio (aOR): 1.5 (1.4–1.7); p<0.01], length of stay [6.5 vs 5.4 days; p<0.01], total hospitalization charges [USD: $65,302 vs $54,149; p<0.01], right heart failure [aOR: 2.4 (1.6–3.6); p<0.01], cardiogenic shock [aOR: 1.9 (1.5–2.5); p<0.01] in influenza patients with AF when compared to those without AF.
Conclusion
Presence of AF is an independent predictor of mortality, length of stay, hospitalization charges, right heart failure and cardiogenic shock in hospitalized patients with influenza. This study helps to assume prognosis and raise awareness on the intensity of care needed toward these patients.
FUNDunding Acknowledgement
Type of funding sources: None.
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