Abstract 20617: Temporal Trends in Drug Abuse in Adults With Atrial Fibrillation show Worse Outcomes
Objective: We sought to determine temporal trends, invasive treatment utilization and impact on outcomes of pre- stroke drug abuse on Atrial Fibrillation (AF) in adults.
Background: Drug abuse is an important risk factor for AF. However, the national epidemiology of drug abuse on AF outcomes in adults has not been yet delineated. We hypothesize that Drug Abuse will be associated with worse outcomes.
Methods: We used the Nationwide Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project (HCUP) from year’s 2002 2012. We identified AF and Drug Abuse as a primary and secondary diagnosis respectively using validated International Classification of Diseases, 9th Revision, and Clinical Modification (ICD 9- CM) codes. We used the Cochrane- Armitage trend test and multivariate regression to generate adjusted odds ratios (aOR).
Results: We analyzed a total of 3,887,827 AF hospital admissions from year’s 2002- 2012 of which 0.91% had Drug Abuse. Proportion of hospitalizations with Drug Abuse increased from 4.05% in 2002 to 17.22% in 2012 (p trend < 0.001). Utilization of Atrial Cardioversion was lower in patients with Drug Abuse (aOR 0.559, 95%CI 0.488-0.641; p < 0.001). In hospital mortality was higher in patients with Drug Abuse (aOR 1.319; 95%CI 0.946 1.838) and discharge to specialty care was significantly higher (aOR 2.594; 95%CI 2.360 2.851; p < 0.001). In addition, median length of hospitalization (1.92 vs. 2.16 days; p < 0.001) and median cost of hospitalization (5,279 vs. 5,142; p < 0.001) did not show clinically significant differences.
Conclusions: We demonstrate that an increasing proportion of adults admitted with AF have drug abuse. However, drug abuse is associated with increased mortality and significantly increased morbidity in adults. Drug abuse is associated with lower Atrial Cardioversion utilization and higher discharge to specialty care. The reasons for the association of drug abuse with mortality and morbidity need to be explored in greater detail.
Author Disclosures: Z. Mansuri: None. M.H. Gul: None. A. Ganti: None. D. Patel: None. K. Chauhan: None. A. Patel: None.
- © 2016 by American Heart Association, Inc.