The clinical impact of paroxysmal arrhythmias on the hospital outcomes of patients admitted with cirrhosis: propensity score matched analysis of 2011–2017 US hospitals. (3rd October 2021)

• Record Type: Journal Article
• Authors: Lee, David Uihwan; Fan, Gregory Hongyuan; Hastie, David Jeffrey; Addonizio, Elyse Ann; Karagozian, Raffi
• Is Part Of: Expert review of cardiovascular therapy. Volume 19:Number 10(2021)
• Page Start: 947
• Page End: 956
• Publication Date: 2021-10-03
• Subjects: PVT -- PSVT -- advanced liver disease -- portal hypertension -- decompensated cirrhosis; Cardiovascular agents -- Research -- Periodicals; 616.12061
• DOI: 10.1080/14779072.2021.1978841
• Languages: English
• ISSNs: 1477-9072

Abstract

ABSTRACT: Background: We evaluate the effects of paroxysmal arrhythmia on the hospital outcomes of patients admitted with cirrhosis. Research design and methods: 2011–2017 National Inpatient Sample was used to isolate patients with decompensated/compensated cirrhosis, stratified by paroxysmal arrhythmia (supraventricular: PSVT and ventricular: PVT). The cohorts were matched using propensity-score matching and compared to mortality, length of stay, cost, and cardiac complications (cardioversion, cardiogenic shock, cardiac arrest, and ventricular fibrillation). Results: In compensated cirrhosis, 2, 453 had PSVT with matched controls; 5, 274 had PVT with matched controls. Those with PSVT had higher mortality (aOR 1.55 95%CI 1.23–1.95) and higher rates of cardioversion and cardiogenic shock; likewise, those with PVT had higher mortality (aOR 2.41 95%CI 2.09–2.78) and higher rates of all complications. In decompensated cirrhosis, 1, 598 had PSVT with matched controls; 4, 178 had PVT with matched controls. Those with PSVT had higher mortality (aOR 1.57 95%CI 1.28–1.93) and higher rates of cardioversion, cardiogenic shock, cardiac arrest; those with PVT had higher mortality (aOR 2.25 95%CI 1.98–2.56) and higher rates of all complications. Conclusion: The findings from this study show that in either decompensated or compensated cohort, those with paroxysmal arrhythmias are at a higher risk of in-hospital mortality and adverse cardiac outcomes.