Abstract
Limited published data exist regarding the association of atrial fibrillation (AF) and acute pancreatitis. To test our hypothesis that AF increases mortality and clinical outcomes in patients with acute pancreatitis, we conducted a cross-sectional data review of the National Inpatient Sample (NIS) database. The NIS database was reviewed for the collection of data on patient hospitalizations in 2016 and 2017. Patients diagnosed with acute pancreatitis with and without concomitant AF were included in the analysis. The International Classification of Diseases, 10th revision coding system was used for the variables of interest. The Stata software program (StataCorp LLC, College Station, TX, USA) was used to perform statistical analyses. The chi-squared test or analysis of variance was used to identify differences in demographic characteristics between the groups. The study population included two groups of patients: those with acute pancreatitis only (n = 542,440) and those with both acute pancreatitis and AF (n = 32,790). The group with acute pancreatitis and AF had a two- to threefold higher rate of mortality [adjusted odds ratio (OR): 2.59; 95% confidence interval (CI): 2.04–3.28] and increased length of stay (adjusted OR: 1.28; 95% CI: 1.08–1.48). Also, significantly higher odds of sepsis (adjusted OR: 2.49; 95% CI: 2.06–3.01), congestive heart failure (adjusted OR: 3.16; 95% CI: 2.87–3.49), acute coronary syndrome (adjusted OR: 1.61; 95% CI: 1.17–2.21), stroke (adjusted OR: 3.94; 95% CI: 1.42–10.93), and acute kidney injury (adjusted OR: 1.42; 95% CI: 1.30–1.55) were observed in patients with acute pancreatitis and AF relative to in patients with acute pancreatitis only. Our results suggest AF increases mortality in patients with acute pancreatitis and that patients with acute pancreatitis and AF are at greater risk of worse clinical outcomes.
Highlights
Acute pancreatitis is an inflammatory condition involving the pancreatic and/or peripancreatic tissues
Mortality in acute pancreatitis can occur in two waves: an early wave due to underlying systemic inflammatory response syndrome (SIRS) and multiorgan dysfunction syndrome (MODS) and a late wave attributed
Influence of atrial fibrillation (AF) in Patients with Acute Pancreatitis: 2016–2017 National Inpatient Sample Database Study to MODS combined with sepsis caused by pancreatic tissue necrosis due to infection.[7]
Summary
Acute pancreatitis is an inflammatory condition involving the pancreatic and/or peripancreatic tissues. It can lead to systemic inflammatory response syndrome (SIRS) and, if severe, can result in multiorgan failure.[1,2,3,4,5,6] Mortality in acute pancreatitis can occur in two waves: an early wave due to underlying SIRS and multiorgan dysfunction syndrome (MODS) and a late wave attributed. Influence of AF in Patients with Acute Pancreatitis: 2016–2017 National Inpatient Sample Database Study to MODS combined with sepsis caused by pancreatic tissue necrosis due to infection.[7] Survival is determined by the early development of SIRS and the persistence of MODS.[8]. When MODS occurs, the cardiovascular system may be affected, which results in cardiac rhythm and contractility disturbances as well as peripheral vasomotor dysfunction. Changes in cardiac physiology have been reported at the histological level, with myofiber edema and disruption of the intercellular junctions.[4,5] These changes at the cellular level can result in hemodynamic, cardiac conduction, and pericardial abnormalities
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