Background: Atrial fibrillation (AF) and -flutter (AFL) are common comorbidities in patients with COPD. AF/AFL has been associated with increased risk of all-cause mortality.

Aim: The aim of this study is to investigate the impact of AF/AFL on all-cause mortality 90 days and one year post hospitalized exacerbation of COPD (hAECOPD) and the risk of mortality associated with persistent AF/AFL at time of hAECOPD.

Method: A retrospective cohort study examining the medical records of patients with hAECOPD in the North Denmark Region. Kaplan-Meier and log-rank test was used to investigate cumulative survival analysis and difference in survival. Cox proportional hazards model was used to investigate difference in all-cause mortality adjusted for age, sex, comorbidities and inhalation medication.

Results: 1444 patients were included. The prevalence of AF/AFL was 23.4% (338/1444), 52.7% (178/338) with persistent and 12.4% (42/338) with first-time AF/AFL.

Kaplan-Meier models showed that patients with AF/AFL had higher risk of all-cause mortality after 90 days (p = 0.002) and 1-year (p = 0.0004), however, cox regression showed no significant association (90-day: HR 1.32, (95% CI 0.95-1.85), p = 0.102; 1-year: 1.21/0.96-1.51) p = 0.103).

Patients with persistent AF/AFL did not have increased mortality risk, judged by Kaplan-Meier (90-day (p = 0.9) and 1-year (p = 0.8)) and corrected cox regression analysis (90-day: 0.71(0.40-1.26) p = 0.238; 1-year: 0.91(0.61-1.35) p = 0.632).

Conclusion: Nor COPD patients with first time- or persistent AF/AFL had increased risk of all-cause mortality at 90-day and 1-year follow-up after correction for age, sex, comorbidities and inhalation medication.