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Burden of Arrhythmia in Hospitalized HIV Patients
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  • Anas Abudan,
  • Vaibhav Vaidya,
  • Byomesh Tripathi,
  • Peter Noseworthy,
  • Daniel DeSimone,
  • Alexander Egbe,
  • Shilpkumar Arora,
  • Haarini Sridhar,
  • Christopher DeSimone,
  • Siva Mulpuru,
  • Abhishek Deshmukh
Anas Abudan
Mayo Clinic
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Vaibhav Vaidya
Mayo Clinic
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Byomesh Tripathi
University of Arizona College of Medicine Phoenix
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Peter Noseworthy
Mayo Clinic
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Daniel DeSimone
Mayo Clinic
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Alexander Egbe
Mayo Clinic
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Shilpkumar Arora
Case Western Reserve University Hospital
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Haarini Sridhar
University of California Berkeley
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Christopher DeSimone
Mayo Clinic
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Siva Mulpuru
Mayo Clinic
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Abhishek Deshmukh
Mayo Clinic
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Abstract

Background: The improved life expectancy observed in patients living with Human Immunodeficiency Virus (HIV) infection has made age-related cardiovascular complications, including arrhythmias, a growing health concern. We describe the temporal trends in frequency of various arrhythmias and assess impact of arrhythmias on hospitalized HIV patients using the Nationwide Inpatient Sample (NIS) Methods and Results: Data on HIV-related hospitalizations from 2005 to 2014 were obtained from the NIS using International Classification of Diseases, 9th Revision (ICD-9) codes. Data was further subclassified into hospitalizations with associated arrhythmias and those without arrhythmia. Baseline demographics and comorbidities were determined. Outcomes including in-hospital mortality, cost of care, and length of stay were extracted. SAS 9.4 (SAS Institute Inc., Cary, North Carolina) was utilized for analysis. A multivariable analysis was performed to identify predictors of arrhythmias among hospitalized HIV patients. Among 2,370,751 HIV-related hospitalizations identified, the overall frequency of any arrhythmia was 3.01%. Atrial fibrillation (AF) was the most frequent arrhythmia (2110 per 100,000). The overall frequency of arrhythmias has increased over time by 108%, primarily due to a 132% increase in AF. Arrhythmias are more frequent among older males, lowest income quartile and non-elective admissions. Patients with arrhythmias had a higher in-hospital mortality rate (9.6%). In-hospital mortality among patients with arrhythmias has decreased over time by 43.8%. The cost of care and length of stay associated with arrhythmia-related hospitalizations were mostly unchanged. Conclusions: Arrhythmias are associated with significant morbidity and mortality in hospitalized HIV patients. AF is the most frequent arrhythmia in hospitalized HIV patients.