Sex-based disparities and in-hospital outcomes of patients hospitalized with atrial fibrillation with and without dementia

• Published in: American heart journal plus Vol. 26; p. 100266
• Main Authors: Baral, Nischit, Mitchell, Joshua D., Aggarwal, Neelum T., Paul, Timir K., Seri, Amith, Arida, Abdul K., Sud, Parul, Kunadi, Arvind, Bashyal, Krishna P., Baral, Nisha, Adhikari, Govinda, Tracy, Melissa, Volgman, Annabelle Santos
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2023; Elsevier
• Subjects: Atrial fibrillation; Cohort study; Dementia; In-hospital mortality; National Inpatient Sample; Research Paper; CHF; In-hospital mortality; AF; CI; Atrial fibrillation; AIDS; DM; HMO; CEVD; CVD; LOS; MCI; National Inpatient Sample; ARIC; Cohort study; NIS; AMI; ARIC-NCS; US; COPD; PVD; Dementia
• ISSN: 2666-6022; 2666-6022
• DOI: 10.1016/j.ahjo.2023.100266

We sought to evaluate the sex-based disparities and comparative in-hospital outcomes of principal AF hospitalizations in patients with and without dementia, which have not been well-studied.
This is a non-interventional retrospective cohort study.
We identified principal hospitalizations of AF in the National Inpatient Sample in adults (≥18 years old) between January 2016 and December 2019.
In-hospital mortality.
Of 378,230 hospitalized patients with AF, 49.2 % (n = 186,039) were females and 6.1 % (n = 22,904) had dementia. The mean age (SD) was 71 (13) years. Patients with dementia had higher odds of in-hospital mortality {adjusted odds ratio (aOR): 1.48, 95 % confidence interval (CI): 1.34, 1.64, p < 0.001} and nontraumatic intracerebral hemorrhage (aOR: 1.60, 95 % CI: 1.04, 2.47, p = 0.032), but they had lower odds of catheter ablation (0.39, 95 % CI: 0.35, 0.43, p < 0.001) and electrical cardioversion (aOR: 0.33, 95 % CI: 0.31, 0.35, p < 0.001). In patients with AF and dementia, compared to males, females had similar in-hospital mortality (aOR: 1.00, 95 % CI: 0.93, 1.07, p = 0.960), fewer gastrointestinal bleeds (aOR: 0.92, 95 % CI: 0.85, 0.99, p = 0.033), lower odds of getting catheter ablation (aOR: 0.79, 95 % CI: 0.76, 0.81, p < 0.001), and less likelihood of getting electrical cardioversion (aOR: 0.78, 95 % CI: 0.76, 0.79, p < 0.001).
Patients with AF and dementia have higher mortality and a lower likelihood of getting catheter ablation and electrical cardioversion.