Abstract 9772: Paroxysmal Atrial Fibrillation Among Pulmonary Embolism Patients; Insight From the 2019 National Inpatient Sample

Introduction: Various factors can trigger events of Pulmonary Embolism(PE). Several studies have linked cardiac arrhythmias such as Paroxysmal Atrial Fibrillation (PAF) with a higher risk of multiple cardiovascular and pulmonary complications. As there is a paucity of data on the risk factors for an event of PAF among PE patients and the factors contributing to death, we conducted a retrospective analysis using the 2019 National Inpatient Sample(NIS). Methods: Our study focused on finding patients with a principal diagnosis of Pulmonary Embolism and a diagnosis of Paroxysmal Atrial Fibrillation. A multivariable regression model evaluated several risk factors for PAF incidence among PE patients and their possible mortality risks. Results: A total of 188,850 cases of PE were observed in our study, including 9,960 (5.3%) cases of PAF. Hyperlipidemia (aOR 1.348, 95% CI 1.290-1.409, p<0.01), hypertension (aOR 1.988, 95% CI 1.887-2.095, p<0.01), and old myocardial infarct (aOR 1.574, 95% CI 1.463-1.693, p<0.01) predisposed to PAF among PE, while females (aOR: 0.873, 95% CI 0.837-0.910, p<0.01), patients with obesity (aOR 0.858, 95% CI 0.818-0.900, p<0.01), and those classified as racially Black (aOR 0.603, 95% CI 0.534-0.681, p<0.01), and Hispanic (aOR 0.653, 95% CI 0.562-0.758, p<0.01) (compared to group excluding Whites, Blacks and Hispanics) reduced their risk. An in-hospital mortality rate of 4.0% was also estimated as 395 patients with PAF died. PAF patients with PE had a higher chance of dying if they also had a diagnosis of diabetes (aOR 1.347, 95% CI 1.070-1.695, p=0.011), whereas those who were obese (aOR 0.421, 95% CI 0.311-0.570, p<0.01), with hyperlipidemia (aOR 0.732, 95% CI 0.590-0.909, p<0.01), and smokers (aOR 0.751, 95% CI 0.606-0.931, p<0.01) expressed a lower risk of mortality. PAF patients with PE reported a higher overall risk of death during hospitalization (aOR 1.322, 95% CI 1.190-1.469, p<0.01). Conclusions: Patients with a diagnosis of PAF while admitted with PE showed a higher risk of mortality. Several factors influenced the presence of PAF among PE patients. It is thus essential for physicians to monitor various cardiovascular complications and arrhythmias in patients admitted with PE.