Length of stay and cost of care associated with admissions for atrial fibrillation among patients with cancer.
Atrial fibrillation
Cancer
Cardio-oncology
Cardioversion
Journal
BMC cardiovascular disorders
ISSN: 1471-2261
Titre abrégé: BMC Cardiovasc Disord
Pays: England
ID NLM: 100968539
Informations de publication
Date de publication:
17 06 2022
17 06 2022
Historique:
received:
09
12
2021
accepted:
01
06
2022
entrez:
17
6
2022
pubmed:
18
6
2022
medline:
22
6
2022
Statut:
epublish
Résumé
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. 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. 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 35715747
doi: 10.1186/s12872-022-02697-4
pii: 10.1186/s12872-022-02697-4
pmc: PMC9205123
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
272Subventions
Organisme : NHLBI NIH HHS
ID : K23 HL155890
Pays : United States
Organisme : NCI NIH HHS
ID : K12 CA133250
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA016058
Pays : United States
Informations de copyright
© 2022. The Author(s).
Références
J Am Coll Cardiol. 2019 Feb 12;73(5):589-597
pubmed: 30732713
JACC CardioOncol. 2020 Dec 15;2(5):747-754
pubmed: 34396290
J Am Coll Cardiol. 2019 Jul 9;74(1):104-132
pubmed: 30703431
Int J Cardiol. 2013 May 10;165(2):355-7
pubmed: 22989607
Circ Cardiovasc Qual Outcomes. 2011 May;4(3):313-20
pubmed: 21540439
Am J Cardiol. 2015 Apr 15;115(8):1090-4
pubmed: 25711434
J Am Coll Cardiol. 2014 Mar 18;63(10):945-53
pubmed: 24361314
ESC Heart Fail. 2019 Aug;6(4):733-746
pubmed: 31264809
J Am Coll Cardiol. 2020 Dec 22;76(25):2982-3021
pubmed: 33309175
N Engl J Med. 2020 Oct 1;383(14):1305-1316
pubmed: 32865375
J Interv Card Electrophysiol. 2021 Apr;60(3):419-426
pubmed: 32377917
JAMA. 2018 Apr 10;319(14):1444-1472
pubmed: 29634829
Europace. 2010 Oct;12(10):1360-420
pubmed: 20876603
Circulation. 2014 Feb 25;129(8):837-47
pubmed: 24345399
Am J Cardiol. 2009 Dec 1;104(11):1534-9
pubmed: 19932788
Curr Oncol Rep. 2019 Apr 4;21(5):45
pubmed: 30949848
Eur J Prev Cardiol. 2021 May 22;28(6):611-621
pubmed: 33624005