Copyright
©The Author(s) 2021.
World J Clin Cases. May 16, 2021; 9(14): 3252-3264
Published online May 16, 2021. doi: 10.12998/wjcc.v9.i14.3252
Published online May 16, 2021. doi: 10.12998/wjcc.v9.i14.3252
Table 1 Patient-level characteristics of rheumatic diseases hospitalizations with atrial fibrillation compared to those without atrial fibrillation, n (%)
| Characteristics | Total | RD with AF | RD without AF | P value |
| n = 3949203 | n = 944705 (23.9%) | n = 3004498 (76.1%) | ||
| Age | < 0.001 | |||
| Age, yr, mean ± SD | 67.6 ± 15 | 75.4 ± 10.8 | 65.1 ± 15.3 | |
| Gender | < 0.001 | |||
| Male | 1811949 (45.9) | 514495 (54.5) | 1297454 (43.2) | |
| Female | 2135719 (54.1) | 429900 (45.5) | 1705819 (56.8) | |
| Missing-1535 | ||||
| Race | < 0.001 | |||
| Caucasians | 2675194 (67.7) | 721595 (76.4) | 1953599 (65) | |
| African-Americans | 653520 (16.5) | 110355 (11.7) | 543165 (18.1) | |
| Others | 620455 (15.7) | 112750 (11.9) | 507705 (16.9) | |
| Comorbidities | ||||
| Congestive heart failure | 682755(17.3) | 290870 (30.8) | 391885 (13) | < 0.001 |
| Coronary arterial disease | 1236959 (31.3) | 444550 (47.1) | 792410 (26.4) | < 0.001 |
| Valvular disease | 188325 (4.8) | 73870 (7.8) | 114455 (3.8) | < 0.001 |
| Obstructive sleep apnea | 504430 (12.8) | 165060 (17.5) | 339370 (11.3) | < 0.001 |
| Chronic pulmonary disease | 954299 (24.2) | 259025 (27.4) | 695275 (23.1) | < 0.001 |
| Hypertension | 2536294 (64.2) | 609890 (64.6) | 1926404 (64.1) | < 0.001 |
| Diabetes w/o chronic complications | 545765 (13.8) | 129010 (13.7) | 416755 (13.9) | < 0.001 |
| Diabetes w/ chronic complications | 676450 (17.1) | 193330 (20.5) | 483120(16.1) | < 0.001 |
| Pulmonary Hypertension | 286580 (7.3) | 135975 (14.4) | 150605 (5) | < 0.001 |
| Hypothyroidism | 628090 (15.9) | 161685 (17.1) | 466405 (15.5) | < 0.001 |
| Renal failure | 1054424 (26.7) | 344655 (36.5) | 709770 (23.6) | < 0.001 |
| Obesity | 716165 (18.1) | 166220 (17.6) | 549945 (18.3) | < 0.001 |
| Alcohol abuse | 123780 (3.1) | 20585 (2.2) | 103195 (3.4) | < 0.001 |
| Drug abuse | 99110 (2.5) | 10800 (1.1) | 88310 (2.9) | < 0.001 |
| Outcomes | ||||
| In-hospital mortality, Missing-3435 | 94495 (2.4) | 37965 (4) | 56530 (1.9) | < 0.001 |
| Adjusted mortality ratio1: 1.46 (1.43-1.48) | ||||
| Length of stay, d, mean ± SD | 5.3 ± 5.9 | 6 ± 6.1 | 5.1 ± 5.9 | < 0.001 |
| Hospitalization cost, $, mean ± SD | 14419 ± 18731 | 15816 ± 20764 | 13981 ± 18023 | < 0.001 |
| Disposition | < 0.001 | |||
| Discharge to home | 2051184 (51.9) | 380575 (40.3) | 1670609 (55.6) | |
| Transfer (to skilled nursing facility, intermediate-care | 881490 (22.3) | 281705 (29.8) | 599785 (19.9) | |
| Home health care | 795225 (20.1) | 214655 (22.7) | 580570 (19.3) | |
| Against medical advice | 33465 (0.8) | 4295 (0.5) | 29170 (0.9) | |
| Missing-3435 | ||||
Table 2 Patient-level characteristics of hospitalizations with specific rheumatic diseases
| Characteristics | Lupus (n = 397935) | Ankylosing Spondylitis (n = 39250) | Sjogren syndrome (n = 114885) | Dermato-polymyositis (n = 30400) | Scleroderma (n = 69865) | Rheumatoid arthritis (n = 1249979) | Gout (n = 1953389) | Reactive arthritis (n = 5690) | Psoriaticarthritis (n = 87110) | Pseudogout (n = 43375) | Polymyalgia rheumatica (n = 172655) | Enteropathic arthritis (n = 935) | Vasculitis (n = 47125) |
| Age, yr, mean ± SD | 52.1 ± 16.9 | 60.2 ± 16.2 | 64 ± 15.5 | 60.6 ± 16.5 | 62.6 ± 14.4 | 67.2 ± 14.2 | 70.5 ± 12.9 | 54.8 ± 17.9 | 60.8 ± 13.9 | 75.4 ± 12.1 | 79.1 ± 9.4 | 45.6 ± 17.4 | 60.9 ± 16.3 |
| Gender | |||||||||||||
| Male | 11.5% | 65.1% | 8.4% | 31.5% | 15.5% | 26% | 67.5% | 63.3% | 42.8% | 48.5% | 31.7% | 37.9% | 47.5% |
| Female | 88.5% | 34.9% | 91.5% | 68.5% | 84.5% | 74% | 32.5% | 36.7% | 57.2% | 51.4% | 68.3% | 62% | 52.5% |
| Elixhauser Comorbidities | |||||||||||||
| Afib. | 9.9% | 14.7% | 14.7% | 16.5% | 17.3% | 18.9% | 30.2% | 12% | 14.7% | 27.1% | 33.2% | 3.2% | 18.2% |
| Coronary Arterial Disease | 17.9% | 21.5% | 18.9% | 21.7% | 22.5% | 25.8% | 38.7% | 16.1% | 21.6% | 28.6% | 35.3% | 7.5% | 22.7% |
| Congestive heart failure | 12.8% | 10.1% | 11% | 14.2% | 17.7% | 14.1% | 21.1% | 8.6% | 8.8% | 15.5% | 18.5% | 5.3% | 15.7% |
| Obstructive sleep apnea | 7.4% | 11.1% | 10.2% | 9.4% | 7.8% | 9.7% | 16.4% | 8.6% | 14.7% | 7.8% | 11.2% | 6.4% | 9.4% |
| Valvular disease | 4% | 3.5% | 4.7% | 3.5% | 5.5% | 4.4% | 5% | 2.7% | 3.2% | 7.1% | 7.5% | 0.5% | 4.3% |
| Chronic pulmonary disease | 22.3% | 19.3% | 24.2% | 18.7% | 23.1% | 27.8% | 22.8% | 17.9% | 21.9% | 18.5% | 23.2% | 17.6% | 28.2% |
| Hypertension | 53.4% | 52.7% | 51.6% | 53.9% | 50.8% | 61.1% | 69.4% | 44.8% | 58.2% | 68.9% | 67.6% | 26.7% | 58.4% |
| Diabetes w/o chronic complications | 8.9% | 11.7% | 8.5% | 14,5% | 6.8% | 12.9% | 15.9% | 7.9% | 13.5% | 12.6% | 12.6% | 9.1% | 8.6% |
| Diabetes w/ chronic complications | 9.7% | 10.6% | 8% | 13.4% | 7% | 12.1% | 23% | 10.7% | 14.4% | 14.2% | 14.6% | 4.8% | 14.2% |
| Pulmonary Hypertension | 6.6% | 3.5% | 7.5% | 8.7% | 29.5% | 5.5% | 8.3% | 2.1% | 3.8% | 4.9% | 6.9% | 1.1% | 5.8% |
| Hypothyroidism | 15.3% | 10.1% | 23.9% | 14.7% | 20.5% | 17.7% | 14.2% | 8.2% | 15.6% | 16.5% | 22.5% | 6.4% | 12.6% |
| Renal failure | 23.5% | 11.5% | 13.3% | 10.9% | 17.4% | 14.7% | 37.1% | 11.1% | 11.6% | 20.6% | 23.6% | 4.8% | 39.1% |
| Obesity | 15.5% | 15.3% | 13.5% | 14.9% | 7.5% | 15.3% | 21.8% | 11.7% | 23.4% | 11.1% | 11.6% | 14.4% | 12.7% |
| Alcohol abuse | 1.7% | 3.5% | 1% | 1.4% | 1.4% | 2.1% | 4.2% | 4.3% | 4.4% | 2.9% | 1.1% | 0.5% | 2.4% |
| Drug abuse | 4.9% | 4.9% | 2.5% | 2.5% | 2.6% | 3.2% | 1.7% | 7.5% | 3.6% | 1.8% | 1.1% | 5.3% | 3.5% |
| Depression | 15.6% | 14.6% | 17.2% | 12.5% | 13.2% | 15.6% | 10.4% | 10.5% | 17.6% | 10.7% | 13.9% | 14.9% | 11.1% |
| Outcomes | |||||||||||||
| In-hospital mortality | 1.9% | 2.4% | 2% | 3.5% | 4.8% | 2.3% | 2.4% | 1.3% | 1.4% | 1.1% | 2.6% | 2.1% | 4% |
| Length of stay, d, mean ± SD | 5.5 ± 6.9 | 5.5 ± 7.4 | 5.1 ± 6.3 | 6.9 ± 8.7 | 6.2 ± 7.6 | 5 ± 5.4 | 5.4 ± 5.9 | 5.8 ± 6.3 | 4.9 ± 5.6 | 6 ± 6.7 | 4.9 ± 4.6 | 5.8 ± 8.6 | 7.1 ± 8.8 |
| Total hospitalization cost, $, mean ± SD | 14389 ± 21148 | 17661 ± 22624 | 14213 ± 19367 | 19190 ± 39030 | 17052 ± 29497 | 13744 ± 16245 | 14566 ± 18344 | 14343 ± 17693 | 14726 ± 18097 | 14742 ± 18924 | 13368 ± 14943 | 16008 ± 25989 | 19874 ± 29132 |
Table 3 Univariate regression analysis for association of atrial fibrillation with rheumatic diseases
| Variables | Odds ratio | 95%CI | P value |
| Lupus | 0.66 | 0.65-0.67 | < 0.0001 |
| Ankylosing spondylitis | 1.03 | 1.01-1.06 | 0.03 |
| Sjogren’s syndrome | 1.03 | 1.02-1.05 | 0.0002 |
| Dermatopolymyositis | 1.19 | 1.15-1.22 | < 0.0001 |
| Scleroderma | 1.26 | 1.24-1.29 | < 0.0001 |
| Polymyalgia rheumatica | 3.00 | 2.97-3.03 | < 0.0001 |
| Vasculitis | 1.34 | 1.31-1.37 | < 0.0001 |
| Rheumatoid arthritis | 1.41 | 1.40-1.42 | < 0.0001 |
| Gout | 2.70 | 2.69-2.71 | < 0.0001 |
| Pseudogout | 2.24 | 2.19-2.29 | < 0.0001 |
| Reactive arthritis | 0.83 | 0.77-0.90 | < 0.0001 |
| Psoriatic arthropathy | 1.04 | 1.02-1.05 | 0.0002 |
| Enteropathic arthropathy | 0.20 | 0.14-0.29 | < 0.0001 |
Table 4 Multiple regression analysis for association of atrial fibrillation with rheumatic diseases after adjusting the sex, age, heart failure, smoking, alcohol, hypertension, diabetes, pulmonary hypertension, valvular disease, coronary artery disease, cardiomyopathy, obstructive sleep apnea and chronic kidney disease
| Variables | Odds ratio | 95%CI | P value |
| Lupus | 1.05 | 1.04-1.06 | < 0.0001 |
| Ankylosing spondylitis | 0.96 | 0.93-0.99 | 0.02 |
| Sjogren’s syndrome | 0.94 | 0.92- 0.95 | < 0.0001 |
| Dermatopolymyositis | 1.14 | 1.10-1.18 | < 0.0001 |
| Scleroderma | 0.96 | 0.93-0.98 | < 0.0001 |
| Polymyalgia rheumatica | 1.15 | 1.14-1.16 | < 0.0001 |
| Vasculitis | 1.19 | 1.16-1.22 | < 0.0001 |
| Rheumatoid arthritis | 1.05 | 1.04-1.05 | < 0.0001 |
| Gout | 1.25 | 1.25-1.26 | < 0.0001 |
| Pseudogout | 1.05 | 1.03-1.08 | < 0.0001 |
| Reactive arthritis | 1.02 | 0.93-1.11 | 0.67 |
| Psoriatic arthropathy | 1.12 | 1.10-1.14 | < 0.0001 |
| Enteropathic arthropathy | 0.44 | 0.30-0.65 | < 0.0001 |
- Citation: Khan MZ, Patel K, Patel KA, Doshi R, Shah V, Adalja D, Waqar Z, Franklin S, Gupta N, Gul MH, Jesani S, Kutalek S, Figueredo V. Burden of atrial fibrillation in patients with rheumatic diseases. World J Clin Cases 2021; 9(14): 3252-3264
- URL: https://www.wjgnet.com/2307-8960/full/v9/i14/3252.htm
- DOI: https://dx.doi.org/10.12998/wjcc.v9.i14.3252