Abstract

ObjectiveTo study the trends of arrhythmia hospitalizations with comorbid alcohol use disorders (AUDs) in terms of demographic characteristics and inpatient outcomes.MethodsWe used the Nationwide Inpatient Sample (NIS) data from 2010 to 2014 and included 570,556 arrhythmia inpatients (age, 15-54 years), and 55,730 inpatients had comorbid AUD. We used the linear-by-linear association test for measuring the differences in demographics, comorbidities, and hospital outcomes over the study period of 2010 to 2014, and the analysis of variance (ANOVA) for measuring the changes seen in the length of stay (LOS) and total charges.ResultsArrhythmia inpatients with AUD were majorly males (85.9%), and older-age adults (45 to 54 years, 68%). Hypertension (52.2%), tobacco abuse (42.3%), and elevated cholesterol and lipids (22.6%) were the most prevalent comorbidities in the study population. There was a statistically significant increasing trend in arrhythmia inpatients with AUD with comorbid diabetes, hypertension, and obesity over the five-year period. In-hospital mortality had a variable trend from 1.1% in 2010 to 1.3% in 2014, but there was a statistically non-significant difference in the trend (P = 0.418). Mean LOS was three days with statistically no significant change during the study period (P = 0.080), whereas total charges have been increasing significantly (P <0.001), averaging $37,473 per hospitalization.ConclusionThe prevalence trend of arrhythmia hospitalizations with comorbid AUD is increasing in the United States population, and is majorly seen in older-age men. Overall, in-hospital mortality in arrhythmia inpatients with comorbid AUD was 1.4%. So, this necessitates the development of an integrated clinical care model for early diagnosis and management of alcohol abuse and dependence in order to improve the arrhythmia patient outcomes and quality of life.

Highlights

  • Holiday heart syndrome (HHS) is an acute cardiac rhythm and/or conduction disturbance associated with heavy ethanol consumption in a person without other clinical evidence of heart disease

  • We used the linear-by-linear association test for measuring the differences in demographics, comorbidities, and hospital outcomes over the study period of 2010 to 2014, and the analysis of variance (ANOVA) for measuring the changes seen in the length of stay (LOS) and total charges

  • In-hospital mortality had a variable trend from 1.1% in 2010 to 1.3% in 2014, but there was a statistically non-significant difference in the trend (P = 0.418)

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Summary

Introduction

Holiday heart syndrome (HHS) is an acute cardiac rhythm and/or conduction disturbance associated with heavy ethanol consumption in a person without other clinical evidence of heart disease. The initial recognition of HHS was a result of a study evaluating 32 dysrhythmic episodes in 24 hospitalized patients who consumed alcohol heavily and regularly; in addition, they took part in a weekend or holiday binge drinking. In their series, the most common cardiac rhythm disturbances were supraventricular tachyarrhythmias (SVT) and atrial fibrillation (AF). The most common cardiac rhythm disturbances were supraventricular tachyarrhythmias (SVT) and atrial fibrillation (AF) This resolved rapidly with spontaneous recovery during subsequent abstinence from alcohol use [1].

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