Mortality and morbidity in patients with atrial fibrillation and liver cirrhosis

Abstract

BACKGROUND Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in clinical practice. However, the outcomes associated with AF in hospitalized patients with liver cirrhosis are unknown. AIM To determine the outcomes of hospitalized patients with liver cirrhosis and AF. METHODS In this study, we examined morbidity and mortality of patients with concomitant AF and liver cirrhosis from the National Inpatient Sample database, the largest publicly available inpatient healthcare database in the United States. RESULTS A total of 696937 patients with liver cirrhosis were included, 45745 of whom had concomitant AF (6.6%). Liver cirrhosis patients with AF had higher rates of in-hospital mortality (12.6% vs 10.3%, P < 0.001), clinical stroke (1.6% vs 1.1%, P < 0.001), and acute kidney injury (28.2% vs 25.1%, P < 0.001), and less gastrointestinal bleeding (4.4% vs 5.1%, P < 0.001) and blood transfusion (22.5% vs 23.8%, P < 0.001) compared with those who did not have the arrhythmia. In addition, they had a longer length of stay (8 ± 10 d vs 7 ± 8 d, P < 0.001) and higher hospitalization costs (20720 ± 33210 $ vs 16272 ± 24166 $, P < 0.001). CONCLUSION In subjects with liver cirrhosis, AF is associated with higher rates of inpatient mortality, stroke, and acute kidney injury compared to those who do not have the cardiac arrhythmia.

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“…Точні причини цієї тенденції невідомі, але вважається, що це може бути пов'язано із збільшенням середньої тривалості життя населення та поширенням відомих факторів ризику ФП -артеріальної гіпертензії, атеросклерозу та інших захворювань судин [9]. За даними статистики, ФП спостерігається у 5 % (95% довірчий інтервал 2,8-8,6) хворих з цирозом печінки, що вище, ніж поширеність ФП у загальній популяції, та супроводжується більш високим рівнем госпіталізації, смертності та частішим виникненням таких тяжких ускладнень, як ішемічний інсульт і гостра ниркова недостатність, порівняно з ізольованим перебігом цирозу печінки [2,4].…”

Anticoagulation for Atrial Fibrillation in Patients with Decompensated Liver Cirrhosis: Bold and Brave?

“…There has been an increasing prevalence of atrial fibrillation (AF) over the last few years with a negative impact on morbidity and mortality [ 1 ]. AF is one of the most common arrhythmias among patients with liver cirrhosis (LC) [ 2 ].…”

“…AF is one of the most common arrhythmias among patients with liver cirrhosis (LC) [ 2 ]. The prevalence of AF in LC patients has been reported to be 11.6%, higher in decompensated LC and patients with alcoholic liver disease or non-alcoholic steatohepatitis (NASH), elderly, or associating comorbidities such as diabetes mellitus, arterial hypertension, chronic obstructive pulmonary disease, and chronic kidney disease [ 1 ]. Cirrhotic patients have been shown to have an increased risk of stroke compared with cirrhotic patients without AF (1.1% vs. 1.6%, p < 0.0001) [ 1 ] in direct relation to LC severity, and higher mortality [ 3 ].…”

Risk Factors of Atrial Arrhythmia in Patients With Liver Cirrhosis: A Retrospective Study

“…This risk does not decrease following liver transplantation. Atrial arrhythmia has been associated with a higher risk of perioperative cardiovascular events and poorer long-term prognoses ( 8 ). Atrial fibrillation or flutter, atrial premature beat, and atrial tachycardia are common atrial arrhythmias.…”