To evaluate whether a documented history of prior thoracic irradiation is associated with differences in in-hospital outcomes for atrial fibrillation or flutter hospitalizations.
Approach:
Study Design: A retrospective cohort study using the National Inpatient Sample (2016–2022) to identify hospitalizations for atrial fibrillation or flutter using ICD-10 codes.
Data Analysis: Propensity score matching followed by post-matching multivariable regression adjustment was used to evaluate outcomes.
Key Findings:
Among 3,198,304 weighted admissions, 8,570 (0.27%) had prior thoracic radiation therapy (TRT).
TRT was associated with higher odds of in-hospital mortality (adjusted odds ratio [aOR] 1.97; 95% CI 1.17–3.32; p=0.010).
Hospitalizations with TRT had a longer length of stay (+0.30 days; 95% CI 0.05–0.55; p=0.019) without increased costs (p=0.202).
Higher odds of palliative consultation (aOR 2.60, p<0.001) and DNR status (aOR 1.97, p<0.001) were noted in TRT patients.
TRT was associated with lower odds of acute kidney injury (aOR 0.66, p<0.001).
Interpretation:
Documented prior thoracic irradiation is associated with higher in-hospital mortality and slightly longer length of stay in patients with atrial fibrillation or flutter.
Limitations:
The study is retrospective and relies on ICD-10 coding, which may have inaccuracies.
Findings may not be generalizable beyond the population represented in the National Inpatient Sample.
Conclusion:
The study highlights the association between prior thoracic irradiation and adverse hospitalization outcomes in patients with atrial tachyarrhythmias.
