Influence of Influenza Infection on In-Hospital Acute Myocardial Infarction Outcomes

Authors

• Byomesh Tripathi, University of Arizona College of Medicine, Phoenix, Arizona.
• Varun Kumar, University of South Florida, Tampa, Florida.
• Ankur Kalra, Cleveland Clinic, Cleveland, Ohio.
• Tanush Gupta, New York Presbyterian Hospital/Columbia University Medical Center, New York, New York.
• Abhishek C. Sawant, University of Arizona College of Medicine, Phoenix, Arizona.
• Purnima Sharma, University of Arizona College of Medicine, Phoenix, Arizona.
• Shilpkumar Arora, Case Western Reserve University, Cleveland Ohio.
• Muhammad S. Panhwar, Tulane University, New Orleans, Louisiana.
• Radha Gopalan, University of Arizona College of Medicine, Phoenix, Arizona.
• Abhishek Deshmukh, Mayo Clinic, Rochester, Minnesota.
• Ashish Pershad, University of Arizona College of Medicine, Phoenix, Arizona.
• Martha Gulati, University of Arizona College of Medicine, Phoenix, Arizona.
• Deepak L. Bhatt, Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts. Electronic address: dlbhattmd@post.harvard.edu.

Document Type

Article

Abstract

Influenza is associated with significant morbidity in the United States but its influence on in-hospital outcomes in patients with AMI has not been well studied. The Nationwide Readmission Database (NRD) from 2010 to 2014 was queried using the International Classification of Diseases-Ninth edition, Clinical Modification (ICD-9-CM) codes to identify all patients ≥18 years who were admitted for AMI with and without concurrent influenza. Propensity score matching was used to adjust patients' baseline characteristics and co-morbidities. In-hospital mortality, 30-day readmission rates, in-hospital complications, and resource utilization were analyzed. We identified a total of 2,428,361 patients admitted with AMI, of whom 3,006 (0.12%) had coexisting influenza. We noted significantly higher in-hospital mortality (7.7% vs 5.6%, p <0.01) and 30-day readmission rates (15.8% vs 14.1%, p <0.01) in patients with influenza compared with those without it. After propensity matching, the differences in in-hospital mortality and 30-day readmission were no longer statistically significant between the groups. Patients with influenza had a higher incidence of acute kidney injury (30.9% vs 24.6%, p <0.01), acute respiratory failure (50.2% vs 32.2%, p <0.01), need for mechanical ventilation (13.9% vs 9.2%, p <0.01), and sepsis (10% vs 3.8%, p <0.01) in the matched cohort. Patients with influenza had longer hospital stays (8.4 days vs 6.4 days, p <0.01) and mean costs of care (26,200USD vs 23,400USD, p <0.01). In conclusion, AMI patients with concomitant influenza infection had higher in-hospital mortality, 30-day readmission, in-hospital complications, and higher resource utilization compared with those without influenza.

Medical Subject Headings

Adolescent; Adult; Cohort Studies; Female; Hospital Mortality; Humans; Influenza, Human (complications); Male; Middle Aged; Myocardial Infarction (complications, mortality); Patient Readmission (statistics & numerical data); Young Adult

Publication Date

9-1-2020

Publication Title

The American journal of cardiology

E-ISSN

1879-1913

Volume

130

First Page

7

Last Page

14

PubMed ID

32636019

Digital Object Identifier (DOI)

10.1016/j.amjcard.2020.05.045

Recommended Citation

Tripathi, Byomesh; Kumar, Varun; Kalra, Ankur; Gupta, Tanush; Sawant, Abhishek C.; Sharma, Purnima; Arora, Shilpkumar; Panhwar, Muhammad S.; Gopalan, Radha; Deshmukh, Abhishek; Pershad, Ashish; Gulati, Martha; and Bhatt, Deepak L., "Influence of Influenza Infection on In-Hospital Acute Myocardial Infarction Outcomes" (2020). Neurology. 2077.
https://scholar.barrowneuro.org/neurology/2077