Abstract
Background: Atrial fibrillation (AF) is the most prevalent arrhythmia in the United Sates. Obesity is a known adverse prognostic factor for several cardiovascular diseases. We aimed to evaluate clinical outcomes in patients hospitalized with AF with history of bariatric surgery versus morbid obesity. Methods: We conducted a retrospective analysis of adult discharges from the National Inpatient Sample (NIS) between 2016 and 2018. ICD Codes were used to identify primary AF hospitalizations. These were further divided into two groups 1. Body mass index (BMI) >/= 35; 2. History of bariatric surgery with BMI < 35. Prevalence estimates were weighted using NIS-provided discharge-level weights to reflect national estimates. Weighted multivariable logistic regression was used to assess the association of history of bariatric surgery vs morbid obesity on various other clinical outcomes in primary AF hospitalizations. These models were adjusted for several patient-level and hospital-level characteristics. Results: There were 7,340 primary AF related hospitalizations with history of bariatric surgery and 159,105 primary AF hospitalizations with morbid obesity. There was no significant difference in adjusted all-cause mortality, use of mechanical circulatory support, cardiac arrest, cardiogenic shock, invasive mechanical ventilation, pressors use or inflation-adjusted cost between the two groups. However, admissions with morbid obesity (in comparison to history of bariatric surgery) were associated with higher rates of acute kidney injury, disposition to short/long term care and length of stay. Conclusion: Our study did not show any difference in mortality and various other outcomes between the two groups. However acute kidney injury, disposition to short/long term care and length of stay were significantly higher for the admissions with morbid obesity.
Published Version
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