COMPARISONS OF OUTCOMES WITH AND WITHOUT HIV IN ATRIAL FIBRILATION

Abstract

SESSION TITLE: Monday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/21/2019 02:30 PM - 03:15 PM PURPOSE: With the advent of anti-retroviral therapy, human immunodeficiency virus (HIV) infection is now becoming a chronic disease. At the end of 2015 the prevalence of HIV was estimated to be 1.1 million persons aged 13 or more according to the CDC. Literature has demonstrated that HIV infection is associated with myocardial infarction, heart failure as well as ischemic stroke. It is not as widely represented in literature between the correlation of HIV as well as atrial fibrillation (AF). We propose a study to evaluate and identify patient outcomes of those with HIV infection and AF. METHODS: We conducted a retrospective analysis of the Healthcare Cost and Utilization Project – Nationwide Inpatient Sample (HCUP-NIS) database. Patients with atrial fibrillation were queried from hospital admissions between 2007 and the September 2015. This was by use of the International Classification of Disease 9th revision (ICD-9) code of ‘472.31’ in all discharge diagnoses. Diagnosis of HIV was queried using the Clinical Classification Software code of ‘5’. Using the statistical software SAS, weighted descriptive analyses were completed to produce national estimates. Variables of hospitalization charges, in-hospital mortality, length of stay, number of procedures during hospitalization, income quartile by zip code and Elixhauser comorbidity index scores were evaluated. SAS was also used for ANOVA with Turkey analysis. RESULTS: Between the years 2007 and September 2015, there was a total of 30,395,295 admissions with AF in the US. Of this, 45,037 patients carried a diagnosis code for HIV. Inpatient mortality for HIV patients was 5% compared to 4.45% without HIV (p<0.05). The mean length of stay for HIV patients was 6.85 vs 5.69 days without HIV (p<0.05). The total charges billed was $62,278 for HIV patients and was $46,293 for without HIV infection (p<0.05). The average number of procedures for those with HIV was higher at 2.12 vs 1.68 for those without (p<0.05). The average household income for those with HIV was 2.04 and those without HIV was 2.45 (p<0.05). Elixhauser mortality index for those with HIV was 8.32 and those without HIV was 7.86 (p<0.05). The mean readmission risk score for those with HIV was 30.41 and those without HIV was 18.73 (p<0.05). CONCLUSIONS: Overall, the outcomes for patients with AF were worse when they had co-infection with HIV. This resulted in longer length of stay, more mortality, higher hospital charges, more procedures along with increased mortality and readmission index scores. It reasonable to say that with HIV becoming a more attributed as a chronic disease, that it may be considered as a risk factor in risk scores such as CHADSVASc. CLINICAL IMPLICATIONS: Further research is needed in the realm of HIV and Atrial Fibrillation to identify the underlying reasons for the above differences and determine if there is a direct pathophysiology between HIV and atrial fibrillation. DISCLOSURES: No relevant relationships by Kathir Balakumaran, source=Web Response No relevant relationships by Anantha Sriharsha Madgula, source=Web Response No relevant relationships by Anand Muthu Krishnan, source=Web Response No relevant relationships by Rudra Ramanathan, source=Web Response No relevant relationships by Varun Tandon, source=Web Response