Atrial Fibrillation Elevates Stroke, Bleeding, and Cost in US Aortic Aneurysm Admissions: Insights from the National...

Aortic aneurysm (AA) and atrial fibrillation (AF) frequently coexist, with emerging evidence suggesting that such patients exhibit an elevated cardiovascular risk profile. However, the impact of preexisting AF on in-hospital outcomes among patients hospitalized for AA remains poorly characterized.

We analyzed data from the National Inpatient Sample (2018-2020) to identify adult hospitalizations with a primary diagnosis of AA. Patients were stratified by the presence or absence of AF. Multivariable logistic and linear regression were used to assess the association of AF with in-hospital mortality, complications, length of stay, and inflation-adjusted total hospital charges.

Among 147,420 weighted AA hospitalizations (mean age: 70 ± 12 years), 39,030 (19.5%) had concomitant AF. After multivariable adjustment, AF was not significantly associated with in-hospital mortality (odds ratio [OR]: 1.07 [0.90, 1.27], P = 0.46). However, patients with AF had a longer median length of stay (5 vs. 2 days; P < 0.001) and incurred higher total charges ($160,363 vs. $129,647; P < 0.001). AF was independently associated with increased odds of ischemic stroke (OR: 1.85 [1.36, 2.51], P < 0.001), transient ischemic attack (OR: 1.96 [1.01, 3.80], P = 0.047), acute myocardial infarction (OR: 1.58 [1.23, 2.04], P < 0.001), and major (OR: 1.21 [1.01, 1.45], P = 0.035) and transfusion-requiring bleeding (OR: 1.90 [1.04, 3.47], P = 0.035).

Although AF was not associated with in-hospital mortality among patients admitted for AA, it was linked to a significantly higher risk of bleeding complications, prolonged hospitalization, and greater health-care expenditures.