Length of stay and cost of care associated with admissions for atrial fibrillation among patients with cancer

Abstract

Background The aim of this study is to assess the burden of AF-related hospitalizations inclusive of inflation-adjusted cost-of-care and length-of-stay (LOS) among cancer patients and the impact of direct current cardioversion (DCCV) on these outcomes. Methods Using the National Inpatient Sample (NIS), patients hospitalized with either a primary or secondary diagnosis of AF and comorbid cancer were identified and both cost of hospitalization and LOS were evaluated for each group. Subgroup analyses were performed for specific cancer types (breast, lung, colon, prostate and lymphoma), and those receiving DCCV. Results The prevalence of co-morbid AF was 8.2 million (16%) and 35.5 million (10%) among those with vs. those without cancer, respectively (odds ratio = 1.6, 95% confidence interval = 1.5–1.7; P < 0.001). Over time, both primary and prevalent AF admissions among those with comorbid cancer increased from 1.1% and 12.3% in 2003 to 1.5% and 21% in 2015, respectively. The total cost of hospitalization increased 94.4% among those with AF and comorbid cancer compared to 23.9% among those without cancer. Among the subgroup of patients with comorbid cancer and primary admission for AF undergoing DCCV, length of stay (2.7 vs. 2.2 days; P < 0.001, model 1) and cost of care ($7,093 vs. 6,152; P < 0.001) were both significantly higher. Conclusions AF related admissions are increasing for all populations especially amongst those patients with a comorbid diagnosis of cancer, including all cancer subtypes evaluated. Among those patients who underwent DCCV, cancer patients had longer length of stay and increased health care costs.

Relationship between nutritional status and length of hospital stay among patients with atrial fibrillation – a result of the nutritional status heart study

“…Regarding length in general, the study by Guha et al showed that the LOHS in the case of primary AF was 1.9 ± 0.002 and in the case of concomitant cancer was 2.9 ± 0.1 days. A significantly longer stay was characterized in this study by the group of patients who underwent direct current cardioversion ( 27 ). In the Vijan et al study, independent factors affecting LOHS (≥7 days for this study) included ACS, decompensated HF, increased NT-proBNP levels and infections ( 25 ).…”