The burden and impact of arrhythmia in chronic obstructive pulmonary disease: Insights from the National Inpatient Sample

Desai, Rupak; Patel, Upenkumar; Singh, Sandeep; Bhuva, Rushikkumar; Fong, Hee Kong; Nunna, Pratyusha; Zalavadia, Dipen; Dave, Hitanshu; Savani, Sejal; Doshi, Rajkumar

doi:10.1016/j.ijcard.2019.01.074

Cited by 32 publications

(33 citation statements)

References 45 publications

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“…The most common arrhythmia in our population, atrial fibrillation (2.87%) is lower than the reported 4% incidence in the general surgery population 11 . The finding that atrial fibrillation as the commonest arrythmia in our cohort, compares well with prior analyses using the NIS for various disease states 5,8,9,13 . It has been hypothesized that low testosterone in transgender females may increase the risk for atrial and ventricular arrhythmia 14 .…”

Section: Discussionsupporting

confidence: 68%

Burden of arrythmias in transgender patients hospitalized for gender‐affirming surgeries

Antwi‐Amoabeng

Doshi

Adalja

et al. 2020

Journal of Arrhythmia

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Background We sought to describe the burden of arrhythmias and their impact on in‐hospital outcomes in transgender patients who underwent gender re‐assignment surgery. Methods The study utilized data from the National Inpatient Sample from January 2012 to September 2015. Results 16 555 adult transgender patients were included in this study. A total of 610 adults developed arrhythmia out of which atrial fibrillation (N = 475, 2.87%) was the most frequent arrhythmia. In‐hospital mortality increased substantially with arrhythmias. Conclusions New‐onset arrythmias, while infrequent in the inpatient setting is associated with significantly higher in‐hospital mortality and resource utilization.

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Section: Discussionsupporting

confidence: 68%

Burden of arrythmias in transgender patients hospitalized for gender‐affirming surgeries

Antwi‐Amoabeng

Doshi

Adalja

et al. 2020

Journal of Arrhythmia

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“…A review summarizing the impact of nonadherence on health care cost in several chronic diseases such as diabetes, CVD, and chronic obstructive pulmonary disease concluded that increasing the medication adherence significantly reduces the overall health care cost [16]. Our prior analyses have revealed close etiopathological and prognostic link of cardiovascular disorders and outcomes with endocrine, respiratory, or psychiatric disorders which also suggests that medications targeted for one organ system can help prevent overall complications, improve quality of life, and improve long-term prognosis [13,[17][18][19][20][21].…”

Section: Discussionmentioning

confidence: 97%

Rising Trends in Medication Non-compliance and Associated Worsening Cardiovascular and Cerebrovascular Outcomes Among Hospitalized Adults Across the United States

Desai

Thakkar

Fong

et al. 2019

Cureus

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Introduction Small-scale studies have described concerning rates of non-compliance/nonadherence towards groups of medications for primary and secondary prevention. Trends in cardiovascular and cerebrovascular events (CCE) among hospitalized patients with a non-compliant behavior towards medication, on the whole, remains unexplored on a large scale. Methods Using the National Inpatient Sample databases (2007-2014), we sought to assess the prevalence and trends in all-cause mortality and CCE in adult patients hospitalized with medication non-compliance. We compared baseline characteristics and comorbidities in the non-compliant patients with and without concomitant in-hospital CCE. Results We identified 7,453,831 adult hospitalizations with medication non-compliance from 2007 to 2014, of which 867,997 (11.6%) patients demonstrated in-hospital CCE. Non-compliant patients with CCE consisted of a higher number of older, white, male patients having greater comorbid risk factors. Non-compliant patients with CCE had higher all-cause in-hospital mortality (3% vs. 0.7%), frequent transfers [4.4% vs. 1.8% transfers to short-term hospitals, and 17.6% vs. 11.6% other transfers (skilled nursing or intermediate care facilities)], lower routine discharges (59.4% vs. 71.1%), and higher mean hospital charges ($52,740 vs. $30,748) compared to non-compliant patients without CCE. Remarkably, this study demonstrates the rising trend in medication non-compliance across all age, sex, and race groups, and related in-hospital mortality, CCE, transfers to other facilities, and the health care cost from 2007 to 2014. Conclusions We observed rising trends in the prevalence of medication non-compliance and subsequent in-hospital mortality in hospitalizations among adults from 2007 to 2014. Non-compliant patients with inpatient CCE demonstrated rising trends in all-cause mortality, complications, health care utilization, and cost from 2007 to 2014.

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“…NIS consists of a 20% stratified sample of all nonfederal community hospitals in the US exclusive of acute and rehabilitation care facilities, and when weighted, it represents 95% of the US population. The NIS data outlines patients’ demographics, up to 25 diagnoses and 15 procedures, hospital characteristics, and comorbidities with relevant International Classification of Diseases Clinical Modification, 9th Revision (ICD-9 CM) codes [ 5 , 19 ]. The current study was exempt from the institutional review board approval owing to the publicly available and de-identified nature of the datasets.…”

Section: Methodsmentioning

confidence: 99%

“…Secondary outcomes were an evaluation of baseline demographics, comorbid conditions, disposition, the mean length of stay (LOS, days), and hospital charges. Coexistent cardiopulmonary conditions and procedures were identified with ICD-9 CM codes as detailed earlier [ 19 - 21 ].…”

Section: Methodsmentioning

confidence: 99%

Nationwide Trends in Cardiovascular and Cerebrovascular Diseases and Outcomes Among Young Adults (18-39 years) Hospitalized With Comorbid Depression

Desai

Valaparla²,

Fong

et al. 2020

Cureus

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Background Modern-day studies that assess temporal trends in cardiovascular and cerebrovascular events (CCE) and outcomes among the young population in the United States (US) with depression remain limited. Methods We compared baseline demographics, comorbidities, all-cause mortality, acute myocardial infarction (AMI), percutaneous coronary interventions (PCI), arrhythmia, stroke, and venous thromboembolism (VTE) among hospitalized young adults (18-39 years) with vs. without depression using the National Inpatient Sample (NIS) from 2007 to 2014. Results A total of 3,575,275 patients out of 63,020,008 hospitalized young adults had comorbid depression (5.7%; median 31 years, 71.3% females). The depressed cohort more often comprised of older, white, male, and non-electively admitted patients. Higher rates of comorbidities, all-cause mortality, PCI, arrhythmia, VTE, and stroke were observed among the depressed cohort. The rising trend in all-cause mortality was observed among the depressed against a stable trend in the non-depressed. The prevalence of AMI remained stable among depressed with consistent upsurges in arrhythmia and stroke. Those with depression had extended hospital stay, higher hospitalization charges, and were more often transferred to other facilities or discharged against advice. Conclusions Rising trends of inpatient mortality, CCE, and higher resource utilization among young adults with depression are concerning and warrants a multidisciplinary approach to improve quality of life and outcomes.

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The burden and impact of arrhythmia in chronic obstructive pulmonary disease: Insights from the National Inpatient Sample

Cited by 32 publications

References 45 publications

Burden of arrythmias in transgender patients hospitalized for gender‐affirming surgeries

Burden of arrythmias in transgender patients hospitalized for gender‐affirming surgeries

Rising Trends in Medication Non-compliance and Associated Worsening Cardiovascular and Cerebrovascular Outcomes Among Hospitalized Adults Across the United States

Nationwide Trends in Cardiovascular and Cerebrovascular Diseases and Outcomes Among Young Adults (18-39 years) Hospitalized With Comorbid Depression

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