Journal article
Impact of frailty in hospitalized patients undergoing catheter ablation for atrial fibrillation
Journal of cardiovascular electrophysiology, Vol.35(10), pp.1929-1938
10/2024
DOI: 10.1111/jce.16383
PMID: 39075813
Abstract
Abstract Background Catheter Ablation (CA) is an effective treatment for atrial fibrillation (AF). However, frail elderly patients have been understudied due to their exclusion from landmark trials. Objectives Our study aims to evaluate outcomes in this population. Methods The national readmission database (2016–2020) was queried, and frailty categories were defined based on hospital risk frailty scores ≦5 as low while >5 as intermediate/high frailty (IHF). We used multivariate regression and propensity‐matched analysis to compare outcomes in patients undergoing CA for atrial fibrillation based on frailty index. Results Among 55 936 CAs for AF, 33,248 patients had low frailty, while 22 688 had intermediate/high frailty (IHF). After propensity matching (N 12 448), IHF patients were found to have higher adverse events, including mortality (3% vs. 0.3%, p < .001), stroke (1.9% vs. 0.2%, p < .001), acute heart failure (53.8% vs. 42.2%, p < .001), AKI (42.5% vs. 6.8%, p < .001), pericardial complications (2.8 vs. 1.6%, p < .001), respiratory complications (27.8 vs. 7.2%, p < .001), major adverse cardiovascular events (21.2 vs. 9.4%, p < .001) and net adverse events (76.7 vs. 55%, p < .001). IHF patients had higher readmissions at 30 (15.5 vs. 12.6%, p < .001), 90 (31.9 vs. 25.1%, p < .001), and 180‐day (41 vs. 34.7%, p < .001) intervals. A higher median length of stay (LOS) (7 vs. 3 days, p < .001) and cost ($44 287 vs. $27 517, p < .001) at index admission and subsequent readmissions were also observed ( p < .001). Conclusion Intermediate/high frailty patients undergoing catheter ablation had worse clinical outcomes, higher healthcare burden, and readmission rates. LOS has decreased in both groups from 2016 to 2020; however, total cost has increased.
Details
- Title: Subtitle
- Impact of frailty in hospitalized patients undergoing catheter ablation for atrial fibrillation
- Creators
- Shafaqat Ali - Louisiana State University in ShreveportManoj Kumar - John H. Stroger, Jr. Hospital of Cook CountyYehya Khlidj - University of Algiers 3Emily Hendricks - West Virginia UniversityFaryal Farooq - Allama Iqbal Medical CollegeWaleed Alruwaili - West Virginia UniversityBijeta Keisham - Weifang Medical UniversitySanchit Duhan - Carle Foundation HospitalKarthik Gonuguntla - West Virginia UniversityYasar Sattar - West Virginia UniversityAyesha Shaik - Hartford HospitalVijaywant Brar - Louisiana State University in ShreveportZain Ul Abideen Asad - University of Oklahoma Medical CenterDan Sorajja - Mayo Clinic in FloridaPaari Dominic - University of IowaTarek Helmy - Louisiana State University in Shreveport
- Resource Type
- Journal article
- Publication Details
- Journal of cardiovascular electrophysiology, Vol.35(10), pp.1929-1938
- DOI
- 10.1111/jce.16383
- PMID
- 39075813
- ISSN
- 1045-3873
- eISSN
- 1540-8167
- Language
- English
- Electronic publication date
- 07/29/2024
- Date published
- 10/2024
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984691560302771
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