The impact of end-stage kidney disease on hospitalization outcomes in patients with complete heart block: insights from united states population data.

Abstract

Introduction: Patients with end stage kidney disease (ESKD) suffer higher rates of mortality, partly because of cardiac conduction abnormalities. Despite this, data on complete heart block (CHB) cases in patients with ESKD remain limited.

Methods: Admissions for CHB were identified in the 2016-2019 National Inpatient Sample. In-hospital outcomes were compared between patients with and without ESKD. The primary outcome was mortality. Secondary outcomes included, Permanent Pacemaker (PPM) and Temporary Pacemaker (TPM) use, palliative care, vasopressor use, mechanical ventilation use, length of stay (LOS), and total charges. Multivariable regression models were used to adjust for confounders.

Results: Among 150,265 hospitalizations with a primary diagnosis of CHB, 5,109 (3.4%) had a diagnosis of ESKD. ESKD was associated with higher odds of mortality (adjusted Odds Ration [aOR] 1.54, 95% CI 1.15-2.07), vasopressors use (aOR 1.9, 95% CI 1.25-2.88), mechanical ventilation (aOR 1.26, 95% CI 1.03-1.56), palliative care (aOR 1.41, 95% CI 1.03-1.94), TPM use (aOR 1.26, 95% CI 1.09-1.47), lower odds of PPM use (aOR 0.54, 95% CI 0.47-0.62), longer LOS (+ 1.29 days, p < 0.001) and higher charges ($123,110 vs. $87,235, p < 0.001).

Conclusion: Patients with ESKD admitted for CHB had higher fatal and non-fatal adverse outcomes compared to patients without ESKD.