Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Quality Measures & Complications D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-198 - Comparative In-hospital Outcomes Of Catheter Ablation For Atrial Fibrillation In Minority And Caucasian Patients: Insights From The National Inpatient Sample (ID 494)

Disclosure
 P.D. Farjo: Nothing relevant to disclose.
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Abstract

Background: Racial disparities have been demonstrated in utilization rates of catheter ablation for atrial fibrillation. Studies to assess outcomes data for minority patients undergoing catheter ablation are sparse.
Objective: We utilized the national inpatient sample (NIS) to compare in-hospital outcomes of white and minority patients who underwent catheter ablation for atrial fibrillation between January 2005 and September 2015.
Methods: Baseline data were compared between groups and outcomes were analyzed using univariate and multivariate regression analyses.
Results: A total of 355,954 patients (300,539 white, 84.4% and 55,415 minority, 15.6%) were included for analysis. From 2005 to 2015 the proportion of minority versus white patients undergoing catheter ablation increased (12.0% vs 88.0% to 17.8 % vs 82.2%). White patients were statistically older, had higher incomes, and tended to have their catheter ablations performed during elective admissions. On the other hand, minority patients had significantly higher rates of heart failure, renal failure, cirrhosis, hypertension, pulmonary hypertension, diabetes mellitus, obesity, drug and alcohol abuse, and CVA. Univariate regression demonstrated minorities had a higher rate of in-hospital mortality (0.72% vs 0.52%, p=0.01) with an odds ratio of 1.34 (95% CI 1.04-1.72), as well as, longer lengths of stay (5.42 days vs 3.95 days, p<0.001) and higher total charges ($103,424 vs $91,479, p<0.001). However, multivariate analysis showed no difference in in-hospital mortality for minorities when accounting for demographic and clinical variables (OR 1.04, 95% CI 0.77-1.41). Minority patients also had higher rates of complications including CVA, venous thromboembolism (VTE), need for blood transfusion, and myocardial infarction (MI). White patients had high rates of cardiac tamponade and complete heart block requiring pacemaker placement.
Conclusion: From 2005 to 2015, minority patients had a higher rate of in-hospital mortality, longer lengths of stay, and higher total charges. They also had more complications including CVA, VTE, need for blood transfusion, and MI. They also tended to have more significant comorbidities when undergoing ablation which attributed to these higher adverse events.
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