Rate of 30-Day Readmission and Economic Burden in Patients With Underlying Metabolic Syndrome Admitted for Atrial Fibrillation

Abstract

BackgroundStudies have demonstrated an increased risk of atrial fibrillation (AF) in patients with underlying metabolic syndrome (MetS); however, no studies examining readmission rates in this population exists to date. Further, impact on mortality and healthcare utilization in this group after readmission remains unknown. MethodsUsing the 2017 National Readmission Database, we conducted a retrospective analysis of patient discharges with AF as principal diagnosis, and MetS as secondary diagnosis. Readmission was defined as the first admission to any hospital for any non-trauma diagnosis within 30-days of index admission; excluding same-day admissions and discharges. Primary outcome was 30-day readmission, while secondary outcomes were readmission mortality rate, most common diagnoses for readmission, and resource utilization. Independent risk factors for readmission were identified using multivariate regression analysis. Results862 patients with underlying MetS were admitted for AF; mean age was 65.2 years [63.9-66.4], and 44% of patients were females. Among this group of readmitted patients, all-cause readmission rate was 9.3% (Figure 1) and in-hospital mortality rate for readmitted patients was 2.5% (p<0.0012). Total hospital days associated with readmission were 410 days, with a total healthcare in-hospital economic burden of $1.4 million. Top diagnoses for readmission included AF, hypertensive heart disease with heart failure, typical atrial flutter, hypertensive heart and chronic kidney disease with heart failure, and sick sinus syndrome, respectively. ConclusionWe observed increased readmission rates and in-hospital mortality in patients readmitted with AF and underlying MetS. Early identification of MetS and disease modification may help improve clinical outcomes and mitigate healthcare burden.