Abstract TP230: Atrial Fibrillation and Short-Term Outcomes After Cancer-Related Ischemic Stroke

Abstract

Introduction: Atrial fibrillation (AF) and cancer are both independently associated with worse outcomes in patients with acute ischemic stroke. Few studies have evaluated the impact of AF on outcomes of cancer-related stroke. We aimed to determine if AF is associated with worse short-term outcomes in patients with stroke and comorbid cancer. Methods: Using the 2016-2019 National Inpatient Sample, we identified all hospitalizations with diagnosis codes for cancer and ischemic stroke. The primary exposure was a diagnosis of AF. The primary outcome was in-hospital mortality. The secondary outcomes were length-of-stay and discharge other than to home. We used multivariable logistic and linear regression models, as appropriate, adjusted for age, gender, race-ethnicity, and the Charlson Comorbidity Index, to examine the association between AF and study outcomes. Results: Among 150,200 hospitalizations with diagnoses of cancer and ischemic stroke (mean age 72 years, 53% male), 40,084 (26.7%) included comorbid AF. Compared to hospitalizations without AF, hospitalizations with AF had higher rates of in-hospital mortality (14.8% vs 12.1%, p<0.001) and non-home discharge disposition (83.5% vs 75.1%, p<0.001) as well as longer mean length-of-stay (8.4 days vs 8.2 days, p<0.001). In multivariable analyses, AF remained independently associated with higher odds of in-hospital mortality (adjusted OR, 1.34; 95% CI, 1.24-1.46), non-home discharge disposition (adjusted OR, 1.32; 95% CI, 1.23-1.42), and longer length-of-stay (adjusted mean difference, 13.7%; 95% CI, 10.9%-16.7%). Conclusions: In cancer-related ischemic stroke, comorbid AF is associated with worse short-term outcomes, including higher odds for in-hospital mortality, worse discharge disposition, and longer hospital stays.