Sickle cell disease‐associated arrhythmias and in‐hospital outcomes: Insights from the National Inpatient Sample

• Main Authors: Upenkumar Patel, Rupak Desai, Bishoy Hanna, Dhruval Patel, Shahzad Akbar, Mohammed Zubair, Gautam Kumar, Rajesh Sachdeva
• Format: Article
• Language: English
• Published: Wiley 2020-12-01
• Series: Journal of Arrhythmia
• Subjects: arrhythmia; atrial fibrillation; mortality; prevalence; sickle cell anemia; sickle cell disease
• Online Access: https://doi.org/10.1002/joa3.12418

Abstract Background The frequency and temporal trend in the prevalence of arrhythmias and associated in‐hospital outcomes in patients with sickle cell disease (SCD) have never been quantified. Methods Our study cohort of SCD patients and sub‐types of arrhythmias were derived from the 2010‐2014 National Inpatient Sample using relevant diagnostic codes. The frequency and trends of arrhythmia and odds of inpatient mortality were measured. Results A total of 891 450 hospitalized SCD patients were identified, of which, 55 616 (6.2%) patients experienced arrhythmias. The SCD cohort with arrhythmia demonstrated higher all‐cause mortality (2.7% vs 0.4%; adjusted OR 2.53, 95% CI 2.15‐2.97, P < .001), prolonged hospital stays (6.9 vs 5.0 days) and higher hospital charges ($53 871 vs $30 905) relative to those without arrhythmias (P < .001).The frequency of supraventricular arrhythmia (AFib, SVT, and AF) and ventricular arrhythmia (VFib and VT) were 1893 and 362 per 100 000 SCD‐related admissions, respectively. Unspecified arrhythmias (4126) were seen most frequently followed by AFib (1622) per 100 000 SCD‐related admissions. From 2010 to 2014, the frequency of any arrhythmias and atrial fibrillation in hospitalized SCD patients relatively increased by 29.6% and 38.5%, respectively. There was nearly a twofold (2.4% in 2010 to 5.0% in 2014) increase in the frequency of arrhythmia among patients aged <18 years. The frequency of arrhythmias in hospitalized male and female SCD patients relatively increased by 28.8% and 31.4%, respectively (Ptrend < .001). Conclusions The frequency of arrhythmias among SCD patients is on the rise with worse hospitalization outcomes, including higher in‐hospital mortality and higher resource utilization as compared to those without arrhythmias.