Inpatient Outcomes of Atrial Fibrillation in Patients With Acute Pancreatitis: Insights From the TriNetX Database

Background: Research regarding the adverse outcomes of atrial fibrillation (AF) in patients with acute pancreatitis (AP) is limited. We hypothesize that the presence of AF is associated with worse inpatient outcomes, including increased mortality and complications in patients admitted with AP. Methods: In this cohort study, de-identified patient data from the US Collaborative Network in TriNetX was used to assess the risk of all-cause mortality and adverse events in patients with AP having AF compared to those without AF within 30 days of the index event from January 1, 2010 to July 6, 2024. Analyses were performed before and after propensity score matching, with risks expressed as odds ratios (OR) with 95% confidence intervals (95% CI), and Kaplan-Meier curves were generated for outcomes. Results: A total of 267 429 patients with AP were identified, of whom 44 621 had a diagnosis of AF. Patients with AP having AF presented with higher comorbidity burdens compared to the non-AF cohort before propensity score matching. After matching, patients with AF exhibited increased risks of all-cause mortality (OR, 1.24; 95% CI, 1.18-1.3), acute kidney injury (OR, 1.17; 95% CI, 1.14-1.2), deep venous thrombosis (OR, 1.33; 95% CI, 1.27-1.39), hemorrhage (OR, 1.06; 95% CI, 1.01-1.11), severe sepsis (OR, 1.3; 95% CI, 1.25-1.35), and requiring critical care services (OR, 1.19; 95% CI, 1.16-1.23). Conclusion: Our results suggest that AF significantly increases the risk of mortality in patients with AP, even after accounting for confounding etiological, comorbid, and pharmacological factors.