Atrial fibrillation in patients with alcohol-associated hepatitis leads to increased mortality
Harshavardhan Sanekommu, Sowmya Dandu, Sneha K. Jayaswal, Mahmut C. Ozkan, Vera Hapshy, Christopher Schreiber, Talal Khurshid Bhatti, Farah Deshmukh, Don C. RockeyBackground
Alcohol consumption is associated with increased risk for development of atrial fibrillation. Outcomes of patients with atrial fibrillation in the context of acute alcohol-associated hepatitis have yet to be investigated.
Methods
We performed a retrospective study of patients with alcohol-associated hepatitis from the National Inpatient Sample (2016–2019), comparing those with and without concurrent atrial fibrillation. Subgroup analysis with and without cirrhosis was alone performed. Statistical analysis performed using STATA 16.1 and multivariate logistic and linear regression.
Results
Among 475 600 patients with alcohol-associated hepatitis, 27 675 (5.8%) had atrial fibrillation. Patients with atrial fibrillation had a nearly two-fold increased in-hospital mortality (6.9%) compared with those without atrial fibrillation (3.9%) [adjusted odds ratio (OR) = 1.35, 95% confidence interval (CI) = 1.20–1.53] and higher odds of developing acute kidney injury (OR = 1.23, 95% CI = 1.15–1.32). They also had longer hospital stays and higher total hospital charges (7.5 vs. 6.0 days and $20 005 vs. $14 714, respectively). Among patients with alcohol-associated hepatitis and atrial fibrillation, 33% also had cirrhosis (
Conclusion
Patients with alcohol-associated hepatitis who have atrial fibrillation have an increased risk of in-hospital mortality and underlying cirrhosis compounds this risk. Early recognition of the effect of concomitant atrial fibrillation and alcohol-associated hepatitis could provide an opportunity for intervention.