Abstract Body:
Background: Carcinoid Tumor (CT) is a rare type of neuroendocrine tumor with a slow-growing nature. CT can affect different parts of the body, but it most commonly affects the gastrointestinal tract or the lungs. The average age of onset is in the early 60s, affecting around 1.5-1.9 people per 100,000 population. Atrial fibrillation (AF) has been associated with CT, however there is limited data about the outcomes associated with AF in the CT population. We aim to assess the impact of AF on mortality and complications in this population.

Methods: The National Inpatient Sample database from 2018 to 2020 was analyzed to identify adult hospitalizations (age > 18) with a diagnosis of CT using appropriate ICD 10 codes. This population was stratified based on concomitant AF. Demographics and complication rates including venous thromboembolic diseases (VTE), acute heart failure (AHF) and acute ischemic stroke (AIS) were studied in these cohorts using a chi-square test for categorical and a t-test for continuous variables. Multivariate regression analysis was further performed to study the impact of AF on complications and mortality after adjusting for relevant confounders.

Results: A total of 70504 adult hospitalizations with CT were identified of which 12.71% (N=8964) had AF. 54% of CT admissions were females and the mean age was 64 years. Hospitalizations with CT and AF had a higher rate of VTE, AHF and AIS (Table 1). Multivariate regression analysis revealed higher odds of AHF and AIS with AF in the subpopulation of adults with CT, while the odds of VTE were statistically insignificant. The odds of mortality with AF were also significantly higher in this subpopulation (Table 2).

Conclusion: Our study concludes that atrial fibrillation portends a worse prognosis in hospitalizations with Carcinoid Tumor. It also shows a higher rate of AHF and AIS in this subgroup with statistically significant odds. Further studies should be done to study the impact of atrial fibrillation in Carcinoid Tumor patients and treatment guidelines for better management of atrial fibrillation in this vulnerable cohort should be formulated to improve patient outcomes.