PO-01-188 PREVALENCE AND OUTCOMES OF ARRHYTHMIAS IN PATIENTS WITH RHEUMATOID ARTHRITIS (RA)

Abstract

Rheumatoid Arthritis (RA) is characterized by increased cardiac morbidity and mortality with >50% of premature deaths associated with cardiovascular disease. RA patients are twice as likely to have sudden cardiac death but there is a paucity of literature evaluating the outcomes related to arrhythmiass. To analyze hospital outcomes in patients with RA and various arrhythmias. We analyzed the National Inpatient Sample Database using ICD-10 codes for patients (>age 18) with RA and various cardiac arrhythmias [SVT, Atrial Flutter, Atrial Fibrillation (AF), Ventricular tachycardia (VT)] versus patients with only RA. Data were extracted from the year 2015 to 2019 and various parameters associated with the procedure were analyzed. This study included 9,370 patients with RA, of which 2,410 (25.7%) patients had concomitant arrhythmias (25.7%). Of those with arrhythmias, 250 (12%) patients had SVT, 1770 (73.4%) patients had AF, 235 (9.8%) patients had atrial flutter, and 155 (6.4%) patients had VT. Patients with RA and an associated arrhythmia had higher inpatient mortality (OR 2.32, CI 1.50-3.59, p<0.0001), length of stay (LOS) (+2.07 days, CI 1.64-2.50, p<0.0001), total hospital charges (THC) (+$83,65.71, CI 2,675.78-14,055.64, p<0.004). Patients with RA and an arrhythmia have increased mortality (OR 58.34, CI 2.14-1,593.73, p<0.016), LOS (+7.66 days, CI 2.04-13.29, p<0.008), and THC (+$80,719.6, CI 24,194.4-137,244.8, p<0.005) if they experienced cardiac arrest (CA) during the hospital course. LOS was increased if patients experienced acute myocardial infarction (MI) (+4.79 days, CI 1.57-8.00, p=0.021), and THC was increased if patients developed cardiogenic shock ($274,790.6, CI 187,462.6-362118.6, p<0.005). Based on our study, patients with RA have a 25.7% risk of an associated arrhythmia. Patients with RA and a concomitant arrhythmia have increased mortality, LOS, and THC. Additionally, our study shows that patients with both RA and an arrhythmia who have an associated cardiac arrest have increased mortality, LOS, and costs. These elevated risks demonstrate the need for adequate arrhythmia screening in patients with RA.