LOS ANGELES – Hospital-acquired bleeding in patients admitted for atrial fibrillation is a very costly event, as demonstrated in the first large national study to put a price tag on this occurrence.
This retrospective observational study was undertaken because even though the clinical and economic toll of stroke in patients with atrial fibrillation (AF) has been well characterized, only scanty information has previously been available on the impact of inpatient bleeding in patients with this most common of arrhythmias, Dr. Alpesh N. Amin explained at the annual scientific sessions of the American Heart Association.
He and his coinvestigators searched the Premier Research Database, which contains patient encounter data from more than 500 U.S. hospitals, in order to identify 143,415 adults hospitalized with a primary diagnosis of nonvalvular AF with no bleeding upon admission during 2008-2011.
A bleeding event requiring administration of blood products occurred in 2.1% of patients. Their unadjusted mean length of stay was 8.8 days, compared with 3.4 days in AF patients without bleeding. After adjustment for comorbid conditions, hospital characteristics, patient demographics, and administration of anticoagulants or antiplatelet agents at any time during the hospitalization, the mean length of stay was 6.7 days in AF patients with bleeding, compared with 3.3 days in those without, according to Dr. Amin, professor and chair of the department of medicine and executive director of the hospitalist program at the University of California, Irvine.
The adjusted mean total cost of the hospital stay in AF patients with hospital-acquired bleeding was $16,621, compared with $6,997 in those without bleeding.
In this study population comprising more than 143,000 patients with AF, bleeding during a hospital stay added roughly $30 million in costs and 10,397 extra days in the hospital, compared with no bleeding.
This study was sponsored by Bristol-Myers Squibb and Pfizer. Dr. Amin reported receiving a research grant from Pfizer.