Abstract 12413: Arrhythmia Burden, Associated Outcomes, and Cost Implications in Patients Hospitalized With Idiopathic Pulmonary Fibrosis

Introduction: Arrhythmias are a common cardiovascular manifestation of idiopathic pulmonary fibrosis (IPF), however, associated costs and hospital outcomes are unknown. We aim to determine the impact of cardiac arrhythmias on outcomes and costs among hospitalized IPF patients.

Methods: A retrospective cohort analysis was conducted using the National Inpatient Sample from 2017-2019. IPF-associated hospitalizations with and without concurrent arrhythmia were compared and identified by appropriate ICD-10 CM codes. The primary outcome was all-cause in-hospital mortality. Secondary outcomes were the duration of hospitalization and associated costs.

Results: Among 92,125 IPF patients, 28.5% (n=26,235) were diagnosed with 29,885 arrhythmias. The most frequent (65%) form of arrhythmias was atrial tachyarrhythmias of which atrial fibrillation was the most predominant (88%). The frequency of bradyarrhythmias, ventricular tachyarrhythmias, and unspecified arrhythmias were 10%, 8%, and 17%, respectively. The IPF-arrhythmia group was predominantly male (64% vs 36%, P < 0.001) and significantly older (76 vs 69 years, p<0.001) with a higher number of comorbidities (3 or more Charlson comorbidity index score: 52% vs 40%, p<0.001). All-cause mortality was significantly higher in the IPF-arrhythmia cohort (12.3% vs. 9.5%, p<0.001) and the odds of in-hospital death remained significantly higher among the IPF-arrhythmia cohort after adjusting for sociodemographic and hospital-level factors (AOR 1.30, 95% CI 1.17-1.44, P <0.001). The hospital length of stay was longer (8.4 vs. 6.7 days, p<0.001), and costs were higher ($123,185 vs. $88,073, p<0.001) among the IPF-arrhythmia cohort.

Conclusions: Concurrent arrhythmias are associated with worse survival outcomes and costs for patients with IPF. Future studies are needed to confirm the benefits of treatment and elucidate the appropriateness and cost-effectiveness of screening for arrhythmias among IPF patients.