Title : Effect of Atrial Flutter on Cardiac Sarcoidosis
Abstract:
Introduction: Cardiac sarcoidosis (CS) is a rare inflammatory condition affecting the myocardium. Frequently CS is associated with arrhythmias such as atrial flutter (AF). Our aim was to characterize the patient demographics of CS patients and investigate the effect of AF on CS.
Methods: This was a retrospective cohort study using the Nationwide Inpatient Sample database to identify admissions in adults with principal and secondary diagnoses of CS and AF from 2019 via ICD-10 diagnostic codes D86.85 and I48.3, I48.4, and I48.92. Multivariate linear and logistic regression models were adjusted for age, gender, race, household income, insurance status, Elixhauser comorbidity score, hospital location, bed size and teaching status. Primary outcome was all-cause mortality, and secondary outcomes were length of stay (LOS) and total charge in USD.
Results: A total of 2,335 admissions with CS were identified, of which 135 patients had AF. Compared to Non-AF-CS cohort, AF-CS cohort had no statistically significant difference in females (33.33% vs 44.77%, p=0.2155), age (59.15 vs 58.50 years, p=07685), White (37.04% vs 46.14%,p=0.3897), Black (44.44% vs 45.91%,p=08911) and Hispanic (7.41% vs 3.18%,p=0.3893) patients. . Compared to Non-AF-CS cohort, AF-CS cohort had more rural hospitalizations (11.11% vs 2.05%, p<0.05), more drug abuse (7.41% vs 1.59%, p<0.05), and more metastatic cancer (3.70% vs 0%, p<0.001).
Compared to Non-AF-CS cohort, AF-CS cohort had higher adjusted all-cause mortality OR 4.79 (95% CI 1.09-21.07,p<0.05), but no significant difference in mortality rate (6.13% vs 4.20%, p=0.0998). There was no statistically significant difference in adjusted overall LOS 0.38 days (95% CI -2.02-2.78, p=0.756). However, Black and Hispanic CS patients had increased LOS of 3.18 days (95% CI 1.21-5.14, p<0.01) and 3.45 days (95% CI 0.0003-6.89, p=0.05) respectively compared to White CS patients. There was no difference in adjusted overall total hospitalization charge - $123,858.6 (95% CI -$29,529.05-$277,246.20, p=0.113). However Black CS patients had $63,381.55 (95% CI 12,304.89-114,458.20, p<0.05) higher in total hospitalization charge compared to White CS patients.
Conclusion: In patients admitted with cardiac sarcoidosis, the presence of atrial flutter was associated with an increased odds of all-cause mortality of 4.79, however, it was not associated with statistically significant differences in mortality rate, overall LOS or overall total hospitalization charge. Racial disparities in LOS and total charge were found as Black and Hispanic patients had 3.18 days and 3.45 days higher LOS compared to White CS patients and Black CS patients had $63,381.55 higher total hospitalization charge compared to White CS patients.
What will audience learn from your presentation?
- Understand patient demographics of patients with cardiac sarcoidosis.
- Understand patient demographics of patients with cardiac sarcoidosis who have concomitant atrial flutter.
- Understand the impact of atrial flutter in the setting cardiac sarcoidosis in terms of mortality, hospital length of stay, and total hospitalization charge.
- Understanding these learning points will improve understanding of this condition and lead to improvement of patient care.
