Abstract 13722: Co-Existing Cardiac Arrhythmia is Associated With Increased Inpatient Mortality in Hospitalized Patients With Systemic Sclerosis: Analysis of the National Inpatient Sample

Abstract

Introduction: Arrhythmias are the most frequent cardiac complications in patients with Systemic Sclerosis (SS). Although associated with high mortality and poor prognosis, hospitalization outcomes for SS patients with arrhythmias are yet to be elucidated. This study aims to determine the burden of cardiac arrhythmias in hospitalized patients with SS. Hypothesis: Co-existing arrhythmia increases mortality and morbidity in hospitalized SS patients. Methods: We searched the National Inpatient Sample (NIS) 2016-2017 databases to identify systemic sclerosis hospitalizations with and without arrhythmia. Using STATA 17 software, we applied multivariate logistic and linear regression to adjust for confounders. The primary outcome was inpatient mortality. Secondary outcomes were mean length of stay (LOS), mean total hospital charge (THC), odds of stroke, heart failure (HF), cardiogenic shock, and cardiac arrest. Results: There were over 71 million discharges in the 2016-2017 NIS database. Out of 63,155 SS hospitalizations, 13,994 (22.1%) had a diagnosis of arrhythmia. SS hospitalizations with arrhythmias had higher inpatient mortality (OR 1.63, CI 1.32-2.01, p<0.001), risk of cardiogenic shock (OR 1.81, CI 1.20-2.73 p=0.005), and cardiac arrest (OR 1.81, CI 1.20-2.73), p=0.005) compared to those without arrhythmias. There was no statistically significant difference in the rates for stroke (OR 1.64, CI 0.75-3.59, p=0.2) and HF (OR 1.15, CI 0.98-1.36, p=0.08) between the two groups. SS and arrhythmia patients had increased adjusted mean LOS by 0.85 days (7 days versus 5 days, p<0.001). Patients with SS and arrhythmias incurred higher adjusted THC than those without arrhythmias (85,184 USD versus 64,152 USD, p<0.001). Conclusion: Hospitalized patients with SS and arrhythmias have increased odds of inpatient mortality, cardiogenic shock, and cardiac arrest compared to those without arrhythmias. Still, the rates of stroke and HF are similar in both groups.