Abstract 18025: Does Co-Morbid Depression Predict Worse In-Hospital Outcomes in Elderly Patients Primarily Hospitalized With Atrial Fibrillation?: A Nationwide Sex and Race Stratified Analysis

Abstract

Introduction: Depression is an established risk factor for major adverse cardiac and cerebrovascular events (MACCE). However, the association between depression (DP) and all-cause mortality, as well as stroke in atrial fibrillation (AF) patients, remains understudied. We aim to establish a relationship between depression and MACCE in AF patients. Methods: Using the National Inpatient Sample (2019) and relevant international classification of disease (ICD-10) codes, we identified hospitalizations with AF among elderly patients (age >65) and categorized them into groups with and without depression (DP vs nDP). The primary outcome was all-cause inpatient mortality and stroke in AF-related hospitalizations. Results: The overall prevalence of depression (DP) among elderly patients hospitalized for AF was 10.6% (32810/310,005). The DP cohort contained less number of males (30.4% vs 44.38%), Blacks ( 2.91% vs 5.77%), Hispanics (4.11% vs 4.68%) while more females (69.59% vs 55.62%) and Whites ( 88.7% vs 83.82%). Stroke prevalence was not significantly different (0.8% vs 0.8% OR:0.97, CI:0.85-1.1 p=0.701) whereas all-cause mortality prevalence was lower in the DP cohort (0.9% vs 1%, OR: 0.85, CI:0.75-0.97 p=0.015). Surprisingly, the subgroup analysis revealed that depressed males exhibited significantly higher odds of stroke, and this association persisted even after multivariable analysis (aOR 1.184, CI: 1.12-3.02, p= 0.016)[Fig 1]. All-cause mortality was higher in depressed blacks(2.6% vs 1.4%, OR:1.84, CI:1.21-2.79, p=0.004) and lower in depressed females (0.8% vs 1.1%, OR:0.78 CI:0.67-0.91, p=0.001). Adjusted multivariable analysis revealed no significant all-cause mortality and stroke in depressed vs non-depressed except for subgroup analysis for elderly depressed males. Conclusion: Depression independently associated with stroke in elderly males hospitalized for AF.