Introduction: Pericardial Tamponade (PT) is a rare, yet fatal complication of influenza virus infection (IVI). Considering the pertaining data remaining limited to case reports, we evaluated the frequency of PT and associated demographic variations, predictors and outcomes of PT in IVI using national multicenter datasets. Methods: We identified adult IVI admissions complicated by PT using National Inpatient Sample (2015Oct-2017) and relevant ICD-10 codes. Primary outcomes for frequency and predictors of PT in IVI and secondary outcomes of all-cause in-hospital mortality and patient discharge were analyzed. The multivariable analysis was performed adjusting for confounders to assess the independent predictors of PT in IVI. Results: Of 380,730 admissions with IVI, 130 (0.03%) patients experienced PT. Overall, young, female, non-white patients more frequently suffered PT during admissions for IVI. Compared to IVI admissions without PT, admissions with PT had significantly nearly six times higher all-cause mortality (23.1% v. 3.4 %, p<0.001). IVI-PT cohort had fewer routine discharges compared to those without PT (30.8% vs. 59.8%, p<0.001). IVI-related admissions who were Hispanics (OR 2.85 [CI 1.66-4.89] p<0.001) in highest income quartile (OR 4.02 [CI 2.40-6.74] p<0.001) with comorbidities like metastatic cancer(OR 6.60 [CI 3.70-11.79] p<0.001), peripheral vascular disease (OR 4.69 [CI 2.65-8.29] p<0.001), prior radiation therapy (OR 3.66 [CI 1.38-9.70] p=0.009), congestive heart failure (OR 3.65 [CI 2.41-5.52] p<0.001), pulmonary circulation disease (OR 3.23 [CI 1.30-8.02] p=0.011), and obesity (OR 2.41 [CI 1.56-3.72] p<0.001) had higher odds of developing PT (Figure 1) . Conclusions: In this multicenter analysis, we found IVI-related admissions among non-whites, patients from high-income quartile with cardiometabolic and oncologic comorbidities had a higher prediction of PT on multivariate analysis.
Background: Preliminary reports have suggested a link between cannabis use and heart failure (HF); however, with inconclusive literature on the subject, there exists an unmet need for contemporary data on outcomes of HF patients with cannabis use. The rising prevalence of Heart Failure with Preserved Ejection Fraction (HFpEF) incited us to assess the impact of cannabis use disorder (CUD) on in-hospital outcomes of HFpEF using nationwide multicenter data. Methods: Adult admissions related to HFpEF with vs. without CUD were identified using the National Inpatient Sample (Oct 2015-Dec 2017). Demographically matched cohorts, HFpEF-CUD+ vs. HFpEF-CUD-, were obtained and compared for comorbidities and in-hospital outcomes. Multivariable regression analyses were performed after controlling for confounders (demographic/hospital characteristics, comorbidities and substance abuse) to assess the risk of adverse outcomes including all-cause mortality, arrhythmia (atrial fibrillation/flutter, ventricular arrhythmia & cardiac arrest) and stroke. Results: Of 3,835,473 HFpEF-related admissions, 10980 (0.3%) patients were cannabis users. Matched cohorts, CUD+ and CUD- were comparable for demographics (median age 55 vs. 54 years, >60% male, >80% white/black). The CUD+ cohort had a lower rate of comorbidities including hypertension (87.5% vs 88.5%), diabetes (33.7% vs 43.7%), hyperlipidemia (38.4% vs 42.1%), obesity (26.7% vs 36.2%), and renal failure (32.8% vs 39.8%) (Table 1). Despite a lower comorbidity burden, the CUD+ cohort was often admitted non-electively (95.2% vs. 92.8%) and had considerably higher odds of all-cause mortality (aOR 2.24, 95%CI:1.81-2.78), arrhythmia (aOR 1.15, 95%CI:1.05-1.25) and cardiac arrest (aOR 3.87, 95%CI: 2.88-5.21) (p<0.05) (Fig. 1). Conclusions: This nationwide multicenter analysis revealed HFpEF admissions in patients with CUD had a significantly higher risk of adverse in-hospital outcomes despite a lower CVD risk.
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