Sickle cell disease-associated arrhythmias and in-hospital outcomes: Insights from the National Inpatient Sample

• Type of Material: Article
• Authors: Upenkumar Patel, Nassau University Medical Center; Rupak Desai, Atlanta VA Medical Center; Bishoy Hanna, Morehouse School of Medicine; Dhruval Patel, L.G. Hospital; Shahzad Akbar, Nassau University Medical Center; Mohammed Zubair, Nassau University Medical Center; Gautam Kumar, Emory University; Rajesh Sachdeva, Emory University
• Language: English
• Date: 2020-12-01
• Publisher: Wiley
• Publication Version: Final Published Version
• Copyright Statement: © 2020 The Authors.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1002/joa3.12418
• Title of Journal or Parent Work: Journal of Arrhythmia
• Volume: 36
• Issue: 6
• Start Page: 1068
• End Page: 1073
• Keywords: sickle cell anemia; sickle cell disease; atrial fibrillation; prevalence; mortality; arrhythmia
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Public Health

Abstract

Background: The frequency and temporal trend in the prevalence of arrhythmias and associated in-hospital outcomes in patients with sickle cell disease (SCD) have never been quantified. Methods: Our study cohort of SCD patients and sub-types of arrhythmias were derived from the 2010-2014 National Inpatient Sample using relevant diagnostic codes. The frequency and trends of arrhythmia and odds of inpatient mortality were measured. Results: A total of 891 450 hospitalized SCD patients were identified, of which, 55 616 (6.2%) patients experienced arrhythmias. The SCD cohort with arrhythmia demonstrated higher all-cause mortality (2.7% vs 0.4%; adjusted OR 2.53, 95% CI 2.15-2.97, P <.001), prolonged hospital stays (6.9 vs 5.0 days) and higher hospital charges ($53 871 vs $30 905) relative to those without arrhythmias (P <.001).The frequency of supraventricular arrhythmia (AFib, SVT, and AF) and ventricular arrhythmia (VFib and VT) were 1893 and 362 per 100 000 SCD-related admissions, respectively. Unspecified arrhythmias (4126) were seen most frequently followed by AFib (1622) per 100 000 SCD-related admissions. From 2010 to 2014, the frequency of any arrhythmias and atrial fibrillation in hospitalized SCD patients relatively increased by 29.6% and 38.5%, respectively. There was nearly a twofold (2.4% in 2010 to 5.0% in 2014) increase in the frequency of arrhythmia among patients aged <18 years. The frequency of arrhythmias in hospitalized male and female SCD patients relatively increased by 28.8% and 31.4%, respectively (Ptrend <.001). Conclusions: The frequency of arrhythmias among SCD patients is on the rise with worse hospitalization outcomes, including higher in-hospital mortality and higher resource utilization as compared to those without arrhythmias.