Relationship of hospital-associated bleeding with length of stay and total hospitalization costs in patients hospitalized for atrial fibrillation

Figures & data

Table 1. Co-morbid condition definitions.

Condition	ICD-9 CM diagnosis code(s)
Acute coronary syndrome	410.xx, 411.xx
Renal insufficiency	580.xx–589.xx
Hypertension	401.xx
Stroke	v12.54, 433.xx-435
Deep vein thrombosis	453.0, 453.2, 453.3, 453.40–453.42, 453.8
Drug and alcohol use/abuse	v11.3, 304, 304.0x–304.9x, 305, 305.0x, 305.2x–305.9x

Table 2. Anti-platelet medications.

aspirin	abciximab
clopidogrel	eptifibatide
prasugrel	tirofiban
ticlopidine	dipyridamole
cilostazol	ticagrelor

Table 3. Anticoagulant medications.

warfarin	argatroban
unfractionated heparin (ufh)	dabigatran
low molecular weight heparin (lmwh)	bivalirudin
lepirudin

Figure 1. Flowchart for patient selection. Retrieved from the Premier database December 2012.

Table 4. Demographic and hospital characteristic comparisons between patients with and without a hospital associated bleeding event in primary atrial fibrillation inpatient visits.

Variable	Bleed (n = 2991)	no Bleed (n = 140,296)	p-value
Age at index (mean, SD)	74.57 (±12.01)	69.34 (±14.51)	<0.0001
age 18–64 (%)	19.9%	34.5%	<0.0001
age 65–74 (%)	23.4%	24.3%	0.2872
age 75+ (%)	56.7%	41.2%	<0.0001
Gender (% female)	55.5%	50.4%	<0.0001
Race (% white)	72.2%	75.2%	0.0002
Payer (% Government)	83.2%	68.3%	<0.0001
Bed size (%)
0–99	2.5%	4.5%	<0.0001
100–199	9.1%	11.4%	<0.0001
200–299	18.0%	17.3%	0.3195
300–499	37.8%	35.9%	0.0288
500+	32.6%	30.9%	0.0528
Urban/Rural (% rural)	13.2%	12.3%	0.1408
Teaching status (% teaching)	37.6%	38.2%	0.4970
Emergency department admission	69.2%	69.2%	0.9903

Table 5. Co-morbidities and cardiac procedure comparison between patients with and without a hospital associated bleeding event in primary atrial fibrillation inpatient visits.

Variable	Bleed (n = 2991)	no Bleed (n = 140,296)	p-value
Renal Insufficiency* (% with)	37.1%	12.9%	<0.0001
Hypertension* (% with)	46.9%	57.7%	<0.0001
Stroke* (% with)	12.0%	8.5%	<0.0001
Deep Vein Thrombosis (DVT)* (% with)	2.6%	0.5%	<0.0001
Acute Coronary Syndrome (ACS)* (% with)	5.5%	2.6%	<0.0001
Drug and Alcohol use* (% with)	3.0%	3.4%	0.3017
Cardiac Procedure at Index Visit (% with)	88.4%	93.5%	<0.0001

*Have ICD-9-CM diagnosis code present on admission.

Table 6. Unadjusted outcomes comparison between patients with and without a hospital associated bleeding event in primary atrial fibrillation inpatient visits.

Variable	Bleed (n = 2991)	no Bleed (n = 140,296)	p-value
Length of stay (days) (mean, SD)	8.6 (±6.4)	3.4 (±2.8)	<0.0001
Median	7.0	3.0
Total cost (US$) (mean, SD)	20,089 (±18,880)	7186 (±7812)	<0.0001
Median	13,122	4793

Table 7. Adjusted outcomes comparisons between patients with and without a hospital associated bleeding event in primary atrial fibrillation inpatient visits.

Variable	Bleed (n = 2989)	no Bleed (n = 140,286)	p-value
Length of stay (days) (mean, 95% CI*)	5.97 (5.83–6.12)	3.26 (3.25–3.27)	<0.0001
Total hospitalization cost (US$) (mean, 95% CI*)	$12,069 ($11,779–$12,366)	$6561 ($6538–$6583)	<0.0001

*Confidence Interval.