Detrimental Impact of Atrial Fibrillation among Patients Hospitalized for Acute Exacerbation of COPD: Results of a Population-Based Study in Spain from 2016 to 2021

Author:

de-Miguel-Diez Javier1ORCID,Lopez-de-Andres Ana2ORCID,Zamorano-Leon José J.2,Hernández-Barrera Valentín3ORCID,Cuadrado-Corrales Natividad2ORCID,Jimenez-Sierra Ana4,Jimenez-Garcia Rodrigo2ORCID,Carabantes-Alarcon David2ORCID

Affiliation:

1. Respiratory Care Department, Hospital General Universitario Gregorio Marañón, 28040 Madrid, Spain

2. Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain

3. Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, 28922 Madrid, Spain

4. Faculty of Medicine, Universidad San Pablo CEU, 28925 Madrid, Spain

Abstract

Background/Objectives: To analyze changes in the prevalence of atrial fibrillation (AF) in patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AE-COPD); to evaluate hospital outcomes according to AF status, assessing sex differences; to identify factors associated with AF presence; and to analyze variables associated with in-hospital mortality (IHM) in AE-COPD patients with AF. Methods: We used data from the Registry of Specialized Care Activity-Basic Minimum Data Set (RAE-CMBD) to select patients aged ≥40 years with COPD in Spain (2016–2021). We stratified the study population according to AF presence and sex. The propensity score matching (PSM) methodology was employed to create comparable groups based on age, admission year, and comorbidities at the time of hospitalization. Results: We identified 399,196 hospitalizations that met the inclusion criteria. Among them, 20.58% had AF. The prevalence of AF rose from 2016 to 2021 (18.26% to 20.95%), though the increase was only significant in men. The median length of hospital stay (LOHS) and IHM were significantly higher in patients with AF than in those without AF. After PSM, IHM remained significantly higher for man and women with AF. Older age, male sex, and several comorbidities were factors associated with AF. Additionally, older age, male sex, different comorbidities including COVID-19, hospitalization in the year 2020, mechanical ventilation, and intensive care unit (ICU) admission were associated with higher IHM in patients with AE-COPD and AF. Conclusions: AF prevalence was high in patients hospitalized for AE-COPD, was higher in men than in women, and increased over time. AF presence was associated with worse outcomes. The variables associated with IHM in hospitalized AE-COPD patients with AF were older age, male sex, different comorbidities including COVID-19 presence, hospitalization in the year 2020, need of mechanical ventilation, and ICU admission.

Funder

Madrid Government

Grupo de Investigación en Epidemiología de las Enfermedades Crónicas de Alta Prevalencia en España

Sociedad Española de Neumología y Cirugía de Tórax (SEPAR), Research Aid 2022

Sociedad Madrileña de Neumología y Cirugía de Tórax

Publisher

MDPI AG

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