The impact of atrial fibrillation in patients with COPD during hospitalization
Authors Chen CY, Liao KM
Received 25 February 2018
Accepted for publication 11 May 2018
Published 10 July 2018 Volume 2018:13 Pages 2105—2112
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Professor Chunxue Bai
Chung-Yu Chen,1–3 Kuang-Ming Liao4
1Master Program in Clinical Pharmacy, School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; 2Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; 3Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; 4Department of Internal Medicine, Chi Mei Medical Center, Chiali, Tainan, Taiwan
Background: Atrial fibrillation (AF) occurs frequently in patients with COPD. There are limited data about the impact of AF in hospitalized COPD patients on other serious health outcomes, such as acute organ dysfunction, severe sepsis, and respiratory failure. The aim of our study was to delineate the impact of AF in hospitalized COPD patients.
Methods: We defined COPD populations with and without AF from the National Health Insurance database in Taiwan. The control subjects (patients with COPD without AF) were selected from the population of COPD patients who had no history of AF and were matched to the COPD patients with AF by age (±1 year), gender, and the year of COPD diagnosis (±1 year). The primary outcome was the time to any first event, which included acute organ dysfunction, severe sepsis, respiratory failure, and death during the hospitalization period. Secondary outcomes, which also included acute organ dysfunction, severe sepsis, respiratory failure, and death, were estimated separately over time.
Results: The primary outcome probability was higher in COPD patients with AF than in COPD patients without AF, with an adjusted HR (aHR) of 1.169 (95% confidence interval [CI]: 1.034–1.320), and higher risks of acute organ dysfunction and respiratory failure were also observed in the former group, with aHRs of 1.179 (95% CI: 1.0370–1.339) and 1.176 (95% CI: 1.006–1.374), respectively.
Conclusion: Compared with COPD patients without AF, those with AF had a higher risk of hepatic dysfunction and respiratory failure.
Keywords: atrial fibrillation, acute organ dysfunction, COPD, respiratory failure, sepsis
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