Abstract 13806: In-Hospital Outcomes Among Patients With Septic Shock and Underlying Chronic Atrial Fibrillation

Abstract

Introduction: Atrial fibrillation (AF) is the leading cause of arrhythmia among hospitalized patients. Altered hemodynamics with new-onset non-valvular atrial fibrillation, especially during sepsis/septic shock, causes decreased organ perfusion, lowers cardiac output, and increases the risk of organ dysfunction leading to increased intensive care unit (ICU) length of stay and mortality. However, little is known about the outcomes of patients hospitalized with septic shock and underlying chronic atrial fibrillation (UCAF). Hypothesis: Does UCAF increase in-hospital mortality in patients who have a diagnosis of septic shock during hospitalization. Methods: This was a retrospective analysis of the 2016 and 2017 Nationwide Readmission Database. ICD-10 codes were used to identify patients with septic shock, and these patients were stratified into those with and without a UCAF. Propensity matching analyses were performed to compare in-hospital mortality and clinical cardiovascular outcomes between the two groups. Results: A total of 353,422 patients with hospitalization for septic shock were identified, 5.8% of whom (n=20,772) had UCAF. After 2:1 propensity matching, 41,438 patients were identified as having septic shock without UCAF, and 20,719 patients were identified as having septic shock with UCAF. In hospital mortality [34.4% vs. 34.1%, p= 0.049], incidence of ischemic stroke [2.5% vs. 2.2%, p = 0.012], acute heart failure [1.8% vs. 1.4%, p < 0.001], length of stay [11.46 days vs. 10.93 days, p< 0.001], mean total charges [$150 4094 vs. $140 4037, p < 0.001] were significantly higher in patients with septic shock and UCAF compared to patients with septic shock without UCAF. Conclusions: The study identified UCAF as an adverse prognosticator for inpatient mortality and severe cardiovascular clinical outcomes. The study suggests the need for future research to improve patient outcomes of patients with septic shock and UCAF.