Abstract P116: African Americans Have the Highest Risk of Stroke-Events and In-Hospital Mortality With Atrial Fibrillation Related Hospitalizations Among All Racial/Ethnic Groups: A Nationwide Analysis

Abstract

Introduction: There continues to be an increase nationwide in hospitalizations for atrial fibrillation (AF). However the impact of age, race and gender on in-patient mortality and stroke events for AF hospitalizations is unknown. Methods: This is a cross-sectional study utilizing data from the 2008 Nationwide Inpatient Sample (NIS). NIS is the largest, all-payer, hospitalization database in USA. We identified all AF-related hospitalizations through the presence of the appropriate ICD-9-CM codes. We calculated the adjusted odds of in-hospital mortality and stroke events with respect to age, gender and race in AF patients using multivariate logistic regression. All analyses were adjusted for the survey design. Results: There were an estimated to 425,470 AF-related hospitalizations in 2008 with 4,041(0.95%) in-hospital deaths and 3,531(0.83%) stroke-related events associated with such hospitalizations, respectively. Table 1 shows the results related to in-hospital mortality and stroke events, adjusted for other comorbidities such as history of diabetes, hypertension, coronary artery disease, myocardial infarction, congestive heart failure and dyslipidemia. Conclusion: African Americans have the highest risk of stroke-events and in-hospital mortality with AF related hospitalizations among all racial/ethnic groups. Increasing age is associated with a large increase in the risk of in-hospital mortality, and a smaller increase in stroke events. Gender was not found to be an independent risk factor for either stroke events or in-hospital mortality for AF. Further research is needed to better characterize the natural history and treatment outcomes in this cohort. Table 1 Odds ratio and confidence limits for in-hospital mortality and stroke events adjusted for co-morbidities. Predictor Comparison In-hospital mortality In-hospital stroke events Point Estimate 95% Wald Confidence Limits p-value Point Estimate 95% Wald Confidence Limits p-value Sex Female vs Male 1.019 0.864 - 1.201 0.82 1.076 0.903 - 1.282 0.41 Race / Ethnicity Black vs White 2.123 1.625 - 2.774 0.0007 2.030 0.731 - 1.450 0.004 Hispanic vs White 1.495 1.068 - 2.093 0.28 1.479 1.061 - 2.062 0.26 Asian or Pacific Islander vs White 1.364 0.752 - 2.477 0.70 0.976 0.481 - 1.982 0.79 Native American vs White 0.732 0.227 - 2.358 0.30 0.260 0.037 - 1.856 0.14 Other vs White 1.083 0.659 - 1.779 0.60 1.282 0.807 - 2.036 0.17 Age 62 - 72 vs ≤ 61 2.454 1.723 - 3.496 0.028 1.277 0.995 - 1.640 0.75 73 - 80 vs ≤ 61 3.997 2.847 - 5.612 0.0001 1.287 0.990 - 1.674 0.69 > 80 vs ≤ 61 7.900 5.721 - 10.910 <.0001 1.476 1.147 - 1.901 0.018