MCL-047 Incidence, Predictors, and Outcomes of Atrial Fibrillation During Hospitalization for Mantle Cell Lymphoma

• Published in: Clinical lymphoma, myeloma and leukemia Vol. 24; pp. S510 - S511
• Main Authors: Imeh, Michael, Gvajaia, Ani, Uwumiro, Fidelis
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.09.2024
• Subjects: atrial fibrillation; mantle cell lymphoma; MCL; outcomes; mantle cell lymphoma; atrial fibrillation; outcomes; MCL
• ISSN: 2152-2650
• DOI: 10.1016/S2152-2650(24)01591-X

Atrial fibrillation (Afib) is reported to complicate up to 16% of hospitalizations for B-cell malignancies. We assessed the incidence rate, predictors, and outcomes of Afib in hospitalizations for mantle cell lymphoma (MCL). We queried the combined 2017–2020 nationwide inpatient sample database for all adult hospitalizations for MCL with or without Afib using ICD-10 codes. Baseline characteristics were compared between hospitalizations with and without Afib using c2 tests and Student's t-test for categorical and continuous variables. The study endpoints included the incidence and predictors of Afib and Afib-related outcomes, including mortality, hospitalization duration, mean hospital costs, and acute in-hospital complications. Predictors of Afib were assessed using stepwise multivariable logistic regression analysis. Illness severity, baseline risk of mortality, and comorbidity burden were adjusted using all patient refined-diagnosis-related groups (APR-DRG) metrics, Charlson comorbidity index (CCI), and Johns Hopkins frailty clusters. We analyzed 9,230 hospitalizations for MCL. The study cohort was mostly male (73.8%) and white Americans (77.2%), with a mean age of 66.8 ± 6.7 years. Afib incidence was 13.8% (n = 1,275). Patients hospitalized with Afib were older (72 vs 66 years; P < .001) and had greater comorbidity (CCI score of ≥3: 73.3 vs 48.0; P < .001). Predictors of Afib included age (aOR: 1.03; 95% CI: 1.01-1.05; P = .001), APR-DRG moderate risk of mortality (aOR: 1.96; 1.09-3.53; P = .025), coexisting congestive cardiac failure (aOR: 2.48; 1.65-3.72; P < .001), and chronic renal disease (aOR: 1.58; 1.02-2.45; P = .039). Hospitalizations for MCL complicated by Afib were correlated with greater mortality (13.7% vs 7.4%; P = .043) and higher incidence of acute heart failure (22.4% vs 6.3%; P = .010), acute ischemic stroke (7.8% vs 0.3%; P < .001), and thromboembolism (15.6% vs 1.1%; P < .001). No significant difference was observed in length of hospital stay (11.2 vs 10.1 days; P = .263) or hospital costs ($183,446 vs $163,151; P = .274). Incidence of Afib was correlated with older age, greater comorbidities, congestive cardiac failure, and chronic renal disease. Afib increased mortality and incidence of acute heart failure, ischemic strokes, and thromboembolism during hospitalization for MCL.