Abstract 13816: Readmission in Patients With Atrial Fibrillation Treated With Dofetilide versus Other Anti-arrhythmic Drug Therapy

Abstract

Listen

Translate article

Introduction: An estimated 3 million people in the U.S. are affected by atrial fibrillation (AF), and its prevalence is projected to increase significantly as the population ages. This study examined time trends of 30-day hospital readmission rates in AF patients treated with dofetilide vs those treated with other antiarrhythmic drug therapy (ADT) and those without ADT (controls). Methods: A retrospective cohort study was conducted using Premier Healthcare Database. The first adult inpatient discharge with ICD-9 diagnosis code 427.31 between 1/1/2007-11/30/2014 was included. Unadjusted descriptive analysis was used to describe the trends of 30-day all-cause and AF-related readmission rates in patients treated with dofetilide, compared to patients with other ADT (amiodarone, sotalol, flecainide, propafenone and dronedarone) and those without ADT. Logistic regressions were used to estimate the association between 30-day readmission and type of anti-arrhythmic treatment. Results: 2,664,043 AF discharges were included. 30-day all-cause readmission rate for dofetilide patients decreased from 10.42% in 2007 to 6.75% in 2014, compared to 3.35% for patients with other ADT, and 3.40% for controls. 30-day AF-related readmission rates dropped by 3.28% in dofetilide, compared to 1.85% in other ADT cohort and 2.42% in controls. Using the no-ADT cohort as reference, the adjusted odds ratios (OR) of 30-day all-cause readmission were 0.76 (95% CI: 0.73-0.80, p<0.001) for dofetilide and 1.10 (95% CI: 1.09-1.11, p<0.001) for other ADT. The adjusted OR of 30-day all-cause readmission were 0.91 (95% CI: 0.86-0.97, p=0.002) for dofetilide and 1.13 (95% CI: 1.12-1.14, p<0.001) for other ADT. The adjusted 30-day all-cause readmission rates were 12.20% for dofetilide, 16.62% for other ADT, and 15.41% for controls. The adjusted AF-related readmission rates were 10.81% for dofetilide, 13.05% for other AA, and 11.71% for controls. Conclusions: There was an 8-year decline in 30-day readmission rates for all cohorts (p<0.001), with a faster decrease in dofetilide patients (p<0.001). The dofetilide treated patients had the lowest adjusted risk of 30-day all-cause and AF-related readmission, while patients undergoing other ADT had the highest readmission rates.