ODP067 Long-term Systemic Steroid Use And Its Impact on In-hospital Outcomes Among Patients Admitted With Acute Pericarditis

Abstract

Abstract Background Early use of systemic steroids in the acute setting of acute pericarditis has been associated with increased recurrence rate and a longer course of treatment. It is not clear if long-term systemic steroids use, has a similar unfavorable impact in patients admitted for acute pericarditis. Our study aimed to determine if the presence of long-term systemic steroid use as a comorbidity during admission for acute pericarditis, was associated with worse outcomes. Method: A retrospective cohort study was designed using data obtained from the 2016 to 2018 combined National Inpatient Sample (NIS) database. The international diseases classification code, tenth revision (ICD-10), was used to identify patients admitted with a principal diagnosis of acute pericarditis who were further dichotomized into 2 cohorts, based on the presence of a secondary diagnosis of long-term systemic steroid use. Primary outcomes of the study were, mortality rate, length of stay (LOS) and total hospital charge. Secondary outcomes assessed included rates of pericardial effusion, cardiac tamponade, cardiogenic shock, pericardial window, and cardiac arrest. A multivariate linear and logistic regression were used to adjust for confounders. Results Our sample included a total of 36,570 adult hospitalizations for acute pericarditis, out of which 2.24% had associated long-term systemic steroid use as a secondary diagnosis. There was a 3- fold increased odds of mortality among patients with long-term systemic steroid use compared to the group without, (2.44% vs 0.84%, AOR: 2.92, 95% CI: 1. 06 to 8. 01, p: 0. 038). Both length of stay (LOS) and total charge were increased among patients with long-term systemic steroid use compared to their counterpart cohort, with an adjusted mean difference of 0.2 days and 1,693.65 USD respectively but these did not meet statistical significance. There was no statistically significant difference in terms of secondary clinical outcomes including, pericardial effusions, cardiac tamponade, cardiogenic shock, rate of pericardial window and cardiac arrest between the two groups analyzed. Conclusion The presence of long-term corticosteroid therapy as a comorbidity during admission for acute pericarditis was associated with a 3–fold increased odds of mortality during hospitalization and there was a trend towards increased LOS and total charge among such patients, though the latter did not meet statistical significance. Further prospective studies need to be done on this topic to better improve understanding and to assess its impact on patient care. Presentation: No date and time listed