Predicting Outcomes in Patients With Atrial Fibrillation and Acute Mesenteric Ischemia

Abstract

Purpose: Outcomes in patients with atrial fibrillation who develop acute mesenteric ischemia, and the impact of anticoagulation on complications, are not defined. Methods: Patients admitted with acute mesenteric ischemia in the National Inpatient Sample from 2007, with and without atrial fibrillation, were compared for in-hospital outcomes using multivariate regression, and the impact of prior anticoagulation determined. Results: Of 48,872 patients with acute mesenteric ischemia, 8,306 had atrial fibrillation, with 680 patients also on anticoagulation. Atrial fibrillation patients were more likely to be older and have hypertension, heart failure, or chronic lung or renal disease. After adjusting for potential confounders, atrial fibrillation remained independently associated with higher mortality (P < 0.001). Patients on anticoagulation were less likely to have intestinal resections or shock, less likely to need intubation and had lesser hospital stay and hospital charges compared to those not on anticoagulation. Conclusions: In patients with acute mesenteric ischemia, presence of atrial fibrillation increases mortality, but prior anticoagulation reduces incidence of complications, length of stay and hospital charges.

Keywords

• acute mesenteric ischemia
• atrial fibrillation
• anticoagulation
• outcomes