Abstract 4145406: The Outcome of Acute Pulmonary Embolism in the Population with Preexisting Atrial Fibrillation

Background: Atrial fibrillation (AF) is the most common arrhythmia. Patients with AF are at high risk of pulmonary embolism (PE). Similarly, patients with PE are at high risk of AF. There is scarcity of data regarding the outcomes of acute pulmonary embolism in the patients with preexisting AF. Methods: This is an analysis of the National Inpatient Sample of the years 2016 to 2020. We identified patients who were admitted with PE using ICD-10-CM codes. We divided the population into two groups by secondary diagnosis of AF. The risk of mortality and in-hospital complications in the PE/AF group was compared to the PE/non-AF group using multivariate logistic regression analysis. Results: During 2016-2020, there were a total of 934225 patients who were admitted with PE, of which 102705(11%) patients had AF. After adjusting for demographics, hospitalized PE patients with AF had higher odds of mortality (aOR (adjusted odds ratio) 1.40; 95% CI 1.30–1.52 p < 0.001), GI bleed (aOR 1.30; 95% CI 1.18–1.43p < 0.001), cardiogenic shock (aOR 1.83; 95% CI 1.64 – 2.04 p< 0.001), cardiac tamponade (aOR 2.93; 95% CI 1.88–4.57 p<0.001) ,cerebral infarction (aOR 1.42; 95% CI 1.21–1.67 p< 0.001),AKI (aOR 1.23; 95% CI 1.18–1.29 p< 0.001), respiratory failure (aOR 1.22; 95% CI 1.18–1.27 p< 0.001), longer LOS (aMD (adjusted mean difference) 0.84 days; 95% CI 0.76– 0.92 days p< 0.001) and higher total cost of care (aMD 9987$; 95% CI 8799 – 11173$ p< 0.001) compared to PE patients without AF. (Figure 1) Conclusion: Hospitalized PE patients with preexisting AF have higher odds of mortality, GI bleed, cardiogenic shock, cardiac tamponade, cerebral infarction, AKI, respiratory failure, longer LOS, and higher total cost of care compared to PE patients without AF. Physicians should be aware of this prognostic effect of AF and include AF in risk stratification of patients with PE.