Impact of atrial fibrillation on inflammatory bowel disease hospitalizations—a nationwide retrospective study

Abstract

Systemic inflammation seen in inflammatory bowel disease (IBD) may cause electrophysiological changes in the atria leading to atrial fibrillation (AF). We analyzed data from the National Inpatient Sample for 2018 to identify all adult hospitalizations with a primary diagnosis of IBD, which were further divided based on the presence or absence of AF. The primary outcome was inpatient mortality while the secondary outcomes included inpatient complications, mean length of stay, and mean total hospital charge. We identified 92,055 IBD hospitalizations, of which 3900 (4.2%) had AF and 88,155 (95.8%) served as controls. IBD hospitalizations with AF were older (70.9 vs. 45.0 years, P < 0.001) and had a higher association with comorbidities compared to the non-AF cohort. Furthermore, the AF cohort had significantly higher adjusted odds of inpatient mortality (2.05% vs. 0.24%; adjusted odds ratio 2.07; 95% confidence interval [CI] 1.09-3.90; P ¼ 0.025), longer length of stay (6.5 vs. 4.9 days; incidence rate ratio 1.23; 95% CI 1.14-1.33; P < 0.001), and higher total hospital charge ($14,587 vs. $11,475; incidence rate ratio 1.26; 95% CI 1.15-1.38; P < 0.001). Additionally, complications such as acute respiratory failure, pulmonary embolism, and necessity of blood product transfusion were more common for IBD hospitalizations with AF than those without.

Inflammatory bowel disease and atrial fibrillation: a contemporary overview

“…Therefore, atrial fibrillation seems to be an independent predictive factor of mortality in hospitalized patients with IBD while patients with advanced age, coronary artery disease, and heart failure have worse outcomes [26]; however, it is not clear whether atrial fibrillation represents a cardiovascular marker of adverse prognosis in this setting or directly promotes the adverse events. In keeping with the aforementioned findings, Kichloo et al demonstrated that atrial fibrillation is associated with increased mortality in hospitalized patients with IBD [27]. This study showed that patients with IBD and atrial fibrillation were older, and had more comorbidities such as diabetes, hypertension, obesity, dyslipidemia, cardiovascular disease, heart failure, and COPD (Table 2).…”

“…In keeping with the aforementioned findings, Kichloo et al . demonstrated that atrial fibrillation is associated with increased mortality in hospitalized patients with IBD [27]. This study showed that patients with IBD and atrial fibrillation were older, and had more comorbidities such as diabetes, hypertension, obesity, dyslipidemia, cardiovascular disease, heart failure, and COPD (Table 2).…”

“…This study showed that patients with IBD and atrial fibrillation were older, and had more comorbidities such as diabetes, hypertension, obesity, dyslipidemia, cardiovascular disease, heart failure, and COPD (Table 2). It also indicated that IBD patients with atrial fibrillation require a longer duration of hospitalization and their hospitalization costs were higher compared to those who did not have atrial fibrillation [27].…”

Exploring the hub mechanisms of ischemic stroke based on protein-protein interaction networks related to ischemic stroke and inflammatory bowel disease

“…Patients with IBD have an abnormal immune response to microbial dysbiosis, leading to a sustained stimulated pro-inflammatory state, and pro-inflammatory Th1, Th17, and γδ T cells are often associated with increased inflammatory injury, while subsets of T cells can help or exacerbate ischemic brain injury 9 , 10 . In addition, inflammatory bowel disease increases patients' risk of atrial fibrillation 11 , predisposes patients to recurrent ischemic cerebrovascular events, and stroke survivors with inflammatory bowel disease are more likely to have a worse prognosis than those without inflammatory bowel disease 12 . In addition, one study used two-sample bidirectional Mendelian randomization (MR) to analyze the relationship between stroke and osteoarthritis (OA), a common general inflammatory disease.…”