Mortality and morbidity in patients with atrial fibrillation and liver cirrhosis

Table 1 Characteristics of hepatic cirrhosis patients stratified by presence of atrial fibrillation among 2003-2014

Characteristic	Non-AF (n = 651192)	AF (n = 45745)	P value
Age (mean ± SD, yr)	54 ± 11	65 ± 11	< 0.001
Female, n (%)	171592 (28.3)	9244 (20.2)	< 0.001
Race, n (%)			< 0.001
Caucasian	343516 (65.8)	30624 (76.2)
African American	57718 (11.1)	3674 (9.1)
Hispanic	91439 (17.5)	4130 (10.3)
Medical comorbidity, n (%)
Hypertension	215381 (35.7)	23136 (50.7)	< 0.001
Diabetes mellitus	126047 (20.8)	12282 (26.8)	< 0.001
Prior sternotomy	8602 (1.4)	2926 (6.4)	< 0.001
Chronic pulmonary disease	106826 (17.6)	14176 (31)	< 0.001
Chronic renal failure	62065 (10.3)	9884 (21.6)	< 0.001
Anemia	186205 (30.8)	13771 (30.1)	0.004
Chronic alcohol use	418372 (69.1)	29194 (63.8)	< 0.001
Hypothyroidism	35221 (5.8)	4662 (10.2)	< 0.001
Peripheral vascular disease	16026 (2.6)	3518 (7.7)	< 0.001
Smoking	159957 (26.4)	8420 (18.4)	< 0.001
Coronary artery disease	31636 (5.2)	6994 (15.3)	< 0.001
Hospital characteristic, n (%)
Teaching hospital	303751 (50.4)	22069 (48.4)	< 0.001
Rural area	57619 (9.6)	4378 (9.6)	0.761
Hospital bed-size			< 0.001
Small	72730 (12.1)	5903 (13)
Medium	156654 (26)	11616 (25.5)
Large	373165 (61.9)	28057 (61.6)
Primary payer, n (%)			< 0.001
Medicare/Medicaid	350547 (57.9)	33371 (73)
Private including HMO	140515 (23.2)	8278 (18.1)
Self-pay	72366 (12)	2287 (5)

AF: Atrial fibrillation; HMO: Health maintenance organization.

Table 2 Characteristics of propensity matched hepatic cirrhosis patients stratified by presence of atrial fibrillation among 2003-2014

Characteristic	Non-AF (n = 45504)	AF (n = 45504)	P value
Age (mean ± SD, yr)	65 ± 11	65 ± 11	0.827
Female, n (%)	9174 (20.2)	9221 (20.3)	0.703
Race, n (%)			0.561
Caucasian	34548 (75.9)	34633 (76.1)
African American	4314 (9.5)	4179 (9.2)
Hispanic	4644 (10.2)	4692 (10.3)
Medical comorbidity, n (%)
Hypertension	23142 (50.9)	22972 (50.5)	0.251
Diabetes mellitus	12456 (27.4)	12229 (26.9)	0.091
Prior sternotomy	2610 (5.7)	2843 (6.2)	0.07
Chronic pulmonary disease	14165 (31.1)	14051 (30.9)	0.404
Chronic renal failure	9595 (21.1)	9751 (21.4)	0.192
Anemia	13623 (29.9)	13690 (30.1)	0.634
Chronic alcohol use	29054 (63.8)	29060 (63.9)	0.972
Hypothyroidism	4456 (9.8)	4603 (10.1)	0.103
Peripheral vascular disease	3420 (7.5)	3463 (7.6)	0.592
Smoking	8264 (18.2)	8405 (18.5)	0.222
Coronary artery disease	6893 (15.1)	6898 (15.2)	0.969
Hospital characteristic, n (%)
Teaching hospital	22061 (48.5)	22129 (48.6)	0.567
Rural area	41154 (90.4)	41141 (90.4)	0.893
Hospital bed-size			0.253
Small	6062 (13.3)	5871 (12.9)
Medium	11469 (25.2)	11569 (25.4)
Large	27973 (61.5)	28064 (61.7)
Primary payer, n (%)			0.052
Medicare/ Medicaid	33277 (73.1)	33138 (72.8)
Private including HMO	8389 (18.4)	8270 (18.2)
Self-pay	2101 (4.6)	2287 (5)

AF: Atrial fibrillation; HMO: Health maintenance organization.

Table 3 In-hospital outcomes of propensity matched hepatic cirrhosis patients stratified by presence of atrial fibrillation among 2003-2014

	Non-AF (n = 45504)	AF (n = 45504)	P value
Clinical outcome, n (%)
In-hospital death	4697 (10.3)	5755 (12.6)	< 0.001
Gastrointestinal bleeding	2329 (5.1)	1995 (4.4)	< 0.001
Blood transfusion	10841 (23.8)	10219 (22.5)	< 0.001
Transient ischemic attack	124 (0.3)	134 (0.3)	0.575
Clinical stroke	496 (1.1)	722 (1.6)	< 0.001
Acute kidney injury	11433 (25.1)	12810 (28.2)	< 0.001
Discharge status, n (%)			< 0.001
Discharged home	27646 (60.8)	25705 (56.5)
Discharged SNF/NH/IC	12242 (26.9)	13114 (28.8)
Length of stay (mean ± SD, d)	7 ± 8	8 ± 10	< 0.001
Hospital cost (mean ± SD, $)	16272 ± 24166	20720 ± 33210	< 0.001

AF: Atrial fibrillation; SNF: Skilled nursing facility; NH: Nursing home; IC: Intermediate care.

Table 4 The prevalence of atrial fibrillation according to age and gender for in-patients with liver cirrhosis compared to the general in-patient population

Age (yr)	Gender	AF in liver cirrhosis (%)	AF national estimate (%)
< 45	Male	1.70	1.76
	Female	0.90	0.88
46-65	Male	5.90	5.91
	Female	3.20	3.16
66-85	Male	20.00	20.03
	Female	16.00	15.99
> 86	Male	34.10	34.18
	Female	33.50	33.60

AF: Atrial fibrillation.