Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

AF Prevalence in Hospitalized Patients with COPD

CHEST; ePub 2019 Jan 23; Xiao, et al

In a large cohort of adult patients with a primary diagnosis of chronic obstructive pulmonary disease (COPD), atrial fibrillation (AF) prevalence in hospital encounters with end-stage COPD increased from 2003 to 2014. Researchers used the 2003 to 2014 Nationwide Inpatient Sample to conduct the retrospective analysis that included all patients aged ≥18 years with a primary diagnosis of COPD on home oxygen who were hospitalized for COPD exacerbation. Multivariate-adjusted models were used to evaluate the association of AF with clinical factors, cost, length of stay (LOS), and hospital outcomes. They found:

  • 1,345,270 patients were included in the analysis; of these 244,488 (18.2%) had AF.
  • The AF prevalence increased from 12.9% in 2003 to 21.3% in 2014 and varied by age, sex, race, income, and hospital region.
  • Prevalence of AF was a risk predictor for in-hospital death, acute respiratory failure, invasive mechanical ventilation, noninvasive mechanical ventilation, acute kidney injury, sepsis, and stroke.
  • AF was associated with increased cost and LOS.


Xiao X, Han H, Wu C, et al. Prevalence of atrial fibrillation in hospital encounters with end-stage COPD on home oxygen. [Published online ahead of print January 23, 2019]. CHEST. doi:10.1016/j.chest.2018.12.021.