Abstract P116: African Americans Have the Highest Risk of Stroke-Events and In-Hospital Mortality With Atrial Fibrillation Related Hospitalizations Among All Racial/Ethnic Groups: A Nationwide Analysis
Introduction: There continues to be an increase nationwide in hospitalizations for atrial fibrillation (AF). However the impact of age, race and gender on in-patient mortality and stroke events for AF hospitalizations is unknown.
Methods: This is a cross-sectional study utilizing data from the 2008 Nationwide Inpatient Sample (NIS). NIS is the largest, all-payer, hospitalization database in USA. We identified all AF-related hospitalizations through the presence of the appropriate ICD-9-CM codes. We calculated the adjusted odds of in-hospital mortality and stroke events with respect to age, gender and race in AF patients using multivariate logistic regression. All analyses were adjusted for the survey design.
Results: There were an estimated to 425,470 AF-related hospitalizations in 2008 with 4,041(0.95%) in-hospital deaths and 3,531(0.83%) stroke-related events associated with such hospitalizations, respectively. Table 1 shows the results related to in-hospital mortality and stroke events, adjusted for other comorbidities such as history of diabetes, hypertension, coronary artery disease, myocardial infarction, congestive heart failure and dyslipidemia.
Conclusion: African Americans have the highest risk of stroke-events and in-hospital mortality with AF related hospitalizations among all racial/ethnic groups. Increasing age is associated with a large increase in the risk of in-hospital mortality, and a smaller increase in stroke events. Gender was not found to be an independent risk factor for either stroke events or in-hospital mortality for AF. Further research is needed to better characterize the natural history and treatment outcomes in this cohort.
|Predictor||Comparison||In-hospital mortality||In-hospital stroke events|
|Point Estimate||95% Wald Confidence Limits||p-value||Point Estimate||95% Wald Confidence Limits||p-value|
|Sex||Female vs Male||1.019||0.864 - 1.201||0.82||1.076||0.903 - 1.282||0.41|
|Race / Ethnicity||Black vs White||2.123||1.625 - 2.774||0.0007||2.030||0.731 - 1.450||0.004|
|Hispanic vs White||1.495||1.068 - 2.093||0.28||1.479||1.061 - 2.062||0.26|
|Asian or Pacific Islander vs White||1.364||0.752 - 2.477||0.70||0.976||0.481 - 1.982||0.79|
|Native American vs White||0.732||0.227 - 2.358||0.30||0.260||0.037 - 1.856||0.14|
|Other vs White||1.083||0.659 - 1.779||0.60||1.282||0.807 - 2.036||0.17|
|Age||62 - 72 vs ≤ 61||2.454||1.723 - 3.496||0.028||1.277||0.995 - 1.640||0.75|
|73 - 80 vs ≤ 61||3.997||2.847 - 5.612||0.0001||1.287||0.990 - 1.674||0.69|
|> 80 vs ≤ 61||7.900||5.721 - 10.910||<.0001||1.476||1.147 - 1.901||0.018|
- © 2012 by American Heart Association, Inc.