title: Relationship of hospital-associated bleeding with length of stay and total hospitalization costs in patients hospitalized for atrial fibrillation.
abstract: BACKGROUND
  While literature has focused on the impact of bleeding beginning outside the hospital setting among patients with atrial fibrillation (AF), there is little information regarding bleeding that first occurs within a hospital setting. This study was performed to determine the association between hospital-associated bleeding in patients admitted for AF on outcomes of length of stay (LOS) and total hospitalization cost.
  
  
  RESULTS
  The Premier research database was queried to identify adult inpatients discharged between 2008-2011 having a primary diagnosis code for AF where a bleeding diagnosis code was not present on admission. Regression was used to adjust for baseline differences in patients to estimate outcomes comparing patients with and without a hospital-associated bleed. There were 143,287 patients that met the study criteria. There were 2991 (2.1%) patients identified with a hospital associated bleed. After adjustment for covariates, the mean estimated LOS was significantly greater in the bleed group, at 6.0 days (95% CI = 5.8-6.1) vs the no bleed group at 3.3 days (95% CI = 3.3-3.3) (p < 0.0001). Similarly, the adjusted mean estimated total hospitalization cost was also significantly greater in the bleed group, $12,069 (95% CI = $11,779-$12,366) vs $6561 (95% CI = $6538-$6583) in the no bleed group (p < 0.0001).
  
  
  CONCLUSIONS
  After adjustments for baseline differences the data show that the 2.1% (n = 2991) of patients with hospital associated bleeding accounted for an estimated additional 8106 hospitalization days and $16.4 million dollars in cost over the study period compared to non-bleeders.
authors.affiliation: a a University of California Irvine , Irvine , CA , USA.
authors.forename: Alpesh N
authors.initials: AN
authors.lastname: Amin
authors.affiliation: b b Premier Research Services , Charlotte , NC , USA.
authors.forename: Scott B
authors.initials: SB
authors.lastname: Robinson
authors.affiliation: b b Premier Research Services , Charlotte , NC , USA.
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Bowdy
authors.affiliation: c c Abbvie , Chicago , IL , USA.
authors.forename: Yonghua
authors.initials: Y
authors.lastname: Jing
authors.affiliation: b b Premier Research Services , Charlotte , NC , USA.
authors.forename: Bernadette H
authors.initials: BH
authors.lastname: Johnson
authors.affiliation: d d Pfizer , New York , NY , USA.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Wiederkehr
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D015897:Comorbidity; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced* / Q000191:economics*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D012189:Retrospective Studies; D012737:Sex Factors; D055815:Young Adult
chemical_list: D000925:Anticoagulants
keywords: Hospital associated bleed; Length of stay; Non-valvular atrial fibrillation; Total hospitalization cost