Adejumo AC, et al. Heart & Lung. 2020 Jan-Feb;49(1):73-79.
Adejumo AC, et al., conducted a study to estimate the distribution and predictors of arrhythmias and their effect on hospitalization findings within end-stage liver disease (ESLD) hospitalizations.
ESLD records were adopted from the nationwide in patient sample (NIS) (2007 – 2014), detected concomitant arrhythmias (tachyarrhythmias and bradyarrhythmias), and their demographic and comorbid attributes, and evaluated the impact of arrhythmia on outcomes. For ESLD, approximately 57,119 (weighted: 277,768) hospitalizations were observed in the US between 2007 – 2014.
Of these, 6615 (11.58%) had a category of cardiac arrhythmia. The most common type of arrhythmia was atrial fibrillation observed at 37.3% which was followed by a wide margin at 10.6%, 9.1%, and 4.6% by cardiac arrest (asystole), ventricular tachycardia, and atrial flutter, respectively (Table 1).
Patients with arrhythmia showed 100% increased odds of mortality, 56% increased odds of non-routine discharges, 20% increased length of stay (almost 1.71 days), and 39% more hospital charges (almost $32,880) as compared to ESLD patients without arrhythmia. Moreover, higher incidence and odds of respiratory failure, mechanical ventilation, shock, kidney failure, dialysis for kidney failure, and the need for cardio version was observed in ESLD patients with arrhythmia. Whereas, no difference was observed in the incidence and odds of stroke, use of balloon pump, and implantation of cardiac device between both groups (Table 2 and figure 1).
Thus, resulting from worse findings with arrhythmias, there is a necessity for better screening and follow-up of ESLD patients for dysrhythmias.
Table 1: Types of cardiac arrhythmias among patients with ESLD in the US, NIS 2007 to 2014
Table 2: Impact of arrhythmia on outcomes of patients’ hospitalized with ESLD in the US, after propensity match-ing, NIS 2012 to 2014
Figure 1: Effects of arrhythmia on outcomes of patients hospitalized for ESLD after pro-pensity matching. Effects are adjusted mean ratio (length of stay and hospital charge) and adjusted odds ratio (others); AKI, acute kidney injury; AICD, automatic implantable cardioverter-defibrillator
