Abstract Body (Do not enter title and authors here): Background:
Atrial fibrillation (AF) is the most common arrhythmia. Patients with AF are at high risk of
pulmonary embolism (PE). Similarly, patients with PE are at high risk of AF. There is scarcity of
data regarding the outcomes of acute pulmonary embolism in the patients with preexisting AF.
Methods:
This is an analysis of the National Inpatient Sample of the years 2016 to 2020. We identified
patients who were admitted with PE using ICD-10-CM codes. We divided the population into
two groups by secondary diagnosis of AF. The risk of mortality and in-hospital complications in
the PE/AF group was compared to the PE/non-AF group using multivariate logistic regression
analysis.
Results:
During 2016-2020, there were a total of 934225 patients who were admitted with PE, of which
102705(11%) patients had AF. After adjusting for demographics, hospitalized PE patients with
AF had higher odds of mortality (aOR (adjusted odds ratio) 1.40; 95% CI 1.30–1.52 p < 0.001),
GI bleed (aOR 1.30; 95% CI 1.18–1.43p < 0.001), cardiogenic shock (aOR 1.83; 95% CI 1.64 –
2.04 p< 0.001), cardiac tamponade (aOR 2.93; 95% CI 1.88–4.57 p<0.001) ,cerebral infarction
(aOR 1.42; 95% CI 1.21–1.67 p< 0.001),AKI (aOR 1.23; 95% CI 1.18–1.29 p< 0.001),
respiratory failure (aOR 1.22; 95% CI 1.18–1.27 p< 0.001), longer LOS (aMD (adjusted mean
difference) 0.84 days; 95% CI 0.76– 0.92 days p< 0.001) and higher total cost of care (aMD
9987$; 95% CI 8799 – 11173$ p< 0.001) compared to PE patients without AF. (Figure 1)
Conclusion:
Hospitalized PE patients with preexisting AF have higher odds of mortality, GI bleed,
cardiogenic shock, cardiac tamponade, cerebral infarction, AKI, respiratory failure, longer LOS,
and higher total cost of care compared to PE patients without AF. Physicians should be aware of
this prognostic effect of AF and include AF in risk stratification of patients with PE.