Abstract W P316

Background and Objectives: Prospective studies have shown Atrial Fibrillation (AF) to be associated with a higher rate of medical complications after Acute Ischemic Stroke (AIS). The effect of AF on resource utilization and in-hospital mortality in AIS is unclear.

Methods: We used the 2011 Nationwide Inpatient Sample (NIS) to identify discharges with a principal diagnosis of AIS using ICD-9 codes 433.01, 433.11, 433.21, 433.31, 433.81, 433.91, 434.01, 434.11, 434.91 and 437.1. Secondary diagnosis of AF was identified using the code 427.31. Endovascular mechanical thrombectomy (EMT) and thrombolysis were identified using the codes 39.74 and 99.10 respectively. Differences in baseline characteristics and resource utilization were tested for the two groups. We used multivariate logistic regression to identify independent predictors of in-hospital mortality.

Results: There was an estimated 467, 849 discharges with AIS of whom 81,922 (17.5%, 95% CI 17.05 - 17.97) had AF. Patients with AF were more likely to be White and female, and had higher rates of HTN and CHF. Patients with AF had longer lengths of stay, higher total charges and more discharges to skilled nursing facilities. A significantly greater proportion of patients with AF received EMT (1.36%) and thrombolysis (7.82%) compared to patients without AF. In-hospital mortality was significantly higher in patients with AF (8.12% vs. 3.76%). In a multivariate logistic regression model adjusted for baseline covariates and procedures, AF was an independent predictor of in-hospital mortality (OR 1.25, 95% CI 1.16 - 1.36, p<0.001)

Conclusions: In a large nationally representative database of discharge related to AIS significant differences existed in resource utilization and in-hospital mortality in patients with AF compared to patients without AF. AF is an independent predictor of in-hospital mortality in patients with AIS.