The clinical impact of paroxysmal arrhythmias on the hospital outcomes of patients admitted with cirrhosis: propensity score matched analysis of 2011–2017 US hospitals

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.

KEYWORDS:

• PVT
• PSVT
• advanced liver disease
• portal hypertension
• decompensated cirrhosis

Declaration of interest

The author(s) have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

David Uihwan Lee: Conceptualization, data curation, formal analysis, investigation, methodology, supervision, validation, writing - original draft, writing - review & editing

Gregory Hongyuan Fan: methodology, writing - original draft, visualization, writing - review & editing

David Jeffrey Hastie: writing - original draft, investigation

Affiliations: Liver Center, Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA

Elyse Ann Addonizio: writing - original draft, investigation

Raffi Karagozian: Supervision, writing - review & editing

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This paper was not funded.