Abstract 12990: Income and Outcomes in Atrial Fibrillation and Atrial Flutter: Insights From the National Inpatient Sample

Abstract

Background: Socioeconomic factors are well-established, important determinants of cardiovascular health. In the United States, the association of personal income on the outcomes of patients with Atrial fibrillation (AF), and atrial flutter is unclear. Hypothesis: Lower socioeconomic status is associated with worse outcomes of patients with AF and atrial flutter. Methods: Utilizing the National Inpatient Sample (NIS), a retrospective descriptive study was conducted. We identified patients admitted for AF and atrial flutter from 2016-2020, our cohort was categorized based on patient income, which was determined using the median income for the patient's zip code. The low-income group(<$50000) included patients in the first quartile of income, while the high-income(≥$50000) group included patients in the second, third, and fourth quartiles of income. We excluded patients who were younger than 18 years of age. Baseline characteristics, presence of comorbidities, and outcomes of the two groups were described. Hypothesis testing for categorical variables was performed using Chi-Square. Continuous variables were tested with a t-test. Statistical significance was defined as a two-tailed P -value of <0.05. The clinical outcomes we evaluated included inpatient mortality, length of stay (LoS), total cost of hospitalization, acute kidney injury (AKI), blood transfusion, and cerebral vascular diseases. Results: In-hospital mortality was observed in 1% of the low-income group and 0.8% in the higher-income group ( P -value <0.0001). LoS was 3.57+/- 0.013 in the low-income group and 3.27+/- 0.008 in the higher-income group. Total cost was $15081.22 in the low-income group and $16307.40 in the higher-income group, AKI (13.8% vs 12.6% in high-income group P -value <0.0001), blood transfusions (1.4% vs 1.1% in the high-income group P -value <0.0001), cerebrovascular disease (4.7% vs 4.5% in high-income group P -value < 0.0006). Conclusion: Our cross-sectional study observed that patients in a lower socioeconomic population had higher mortality during hospitalizations, and increased risk of cerebrovascular disease.