Abstract
Background
Acute respiratory distress syndrome (ARDS) is associated with high mortality. Atrial
fibrillation (AF) is a common arrhythmia seen in critically ill patients. The impact
of AF on the outcomes in patients with ARDS is less understood. In this analysis we
attempt to evaluate the association of concurrent AF and various clinical outcomes
in patients with ARDS.
Methods
We conducted a retrospective analysis of adult discharges from the National Inpatient
Sample (NIS) between 2004 and 2014. International Classification of Disease codes
were used to identify those with ARDS and AF.
Results
We found 1,200,737 hospitalizations with ARDS, out of which 238,455 had concomitant
diagnosis of AF. Hospitalizations with AF had higher prevalence of comorbidities including
chronic pulmonary disease, diabetes mellitus, hypertension, obesity, congestive heart
failure and renal failure. On adjusted analysis, AF was associated with increased
odds of acute myocardial infarction, cardiogenic shock, pressor use, acute kidney
injury, permanent pacemaker implantation, cardiac arrest, mechanical circulatory support
use and higher length of stay and inflation-adjusted cost in hospitalizations with
ARDS. However, there was no significant difference in adjusted all-cause mortality
in ARDS with and without AF (25.42% vs 20.23%, p=0.53).
Conclusions
AF is associated with worse clinical outcomes, higher length of stay and cost in ARDS
hospitalizations as compared to those without AF.
Keywords
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Article info
Publication history
Published online: February 05, 2022
Accepted:
January 31,
2022
Received:
June 19,
2021
Identification
Copyright
© 2022 Published by Elsevier Inc. on behalf of Southern Society for Clinical Investigation.
