Prevalence and Clinical Impact of Atrial Fibrillation in Patients with Pulmonary Embolism

Objectives Atrial fibrillation (AF) has been suggested as a cause for pulmonary embolism (PE). We aimed to explore the prevalence and clinical impact of AF in patients with PE. Methods Using the 2012-2014 National (Nationwide) Inpatient Sample database, we identified "adult patients with PE" as the principal discharge diagnosis. The identified admissions were stratified into two cohorts based on the presence or absence of AF. We used multivariable regression models to evaluate in-hospital mortality, length of stay, nonhome discharge, and in-hospital complications. Results The prevalence of AF among the 201,360 patients with PE was 11.62%. Patients with AF were more likely to have massive PE (odds ratio 1.59, 95% confidence interval 1.4-1.81, P < 0.001), with higher mortality (adjusted odds ratio 1.48, 95% confidence interval 1.27-1.71, P < 0.001) and a greater risk of mechanical ventilation, cardiac arrest, and nonhome discharges. The length of hospital stay in patients with PE and comorbid AF was significantly longer than those without (6.24 +/- 0.10 vs 4.79 +/- 0.03 days). Conclusions AF is associated with a higher rate of massive PE, higher in-hospital mortality, a longer length of hospital stay, and a higher incidence of in-hospital complications and nonhome discharge.