New-onset atrial fibrillation and clinical outcome in non-cardiac intensive care unit patients

Makrygiannis, Stamatis S.; Rizikou, Despina; Patsourakos, Nikolaos G.; Lampakis, Manolis; Margariti, Apostolia; Ampartzidou, Olga S.; Sakellaridis, Konstantinos; Tselioti, P.; Pipilis, Athanasios; Prekates, A.

doi:10.1016/j.aucc.2017.08.002

Cited by 11 publications

(7 citation statements)

References 21 publications

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“…AF in critically ill patients may be new-onset or recurrent [ 33 ]. Advanced age is considered one of the most potent risk factors for independently predicting AF [ 34 ]. In our study, compared to patients younger than 45 years, those older than 75 years were nearly 10-fold more likely to develop AF.…”

Section: Discussionmentioning

confidence: 99%

Atrial fibrillation in critically ill patients who received prolonged mechanical ventilation: a nationwide inpatient report

Lin

Han

Guo

et al. 2021

Korean J Intern Med

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Background/Aims: To evaluate temporal trends of atrial fibrillation (AF) prevalence in critically ill patients who received prolonged mechanical ventilation (MV) in the United States. Methods: We used the 2008 to 2014 National Inpatient Sample to compute the weighted prevalence of AF among hospitalized adult patients on prolonged MV. We used multivariable-adjusted models to evaluate the association of AF with clinical factors, in-hospital mortality, hospitalization cost, and length of stay (LOS). Results: We identified 2,578,165 patients who received prolonged MV (21.27% of AF patients). The prevalence of AF increased from 14.63% in 2008 to 24.43% in 2014 (p for trend < 0.0001). Amongst different phenotypes of critically ill patients, the prevalence of AF increased in patients with severe sepsis, asthma exacerbation, congestive heart failure exacerbation, acute stroke, and cardiac arrest. Older age, male sex, white race, medicare access, higher income, urban teaching hospital setting, and Western region were associated with a higher prevalence of AF. AF in critical illness was a risk factor for in-hospital death (odds ratio, 1.13; 95% confidence interval, 1.11 to 1.15), but in-hospital mortality in critically ill patients with AF decreased from 11.6% to 8.3%. AF was linked to prolonged LOS (2%, p < 0.0001) and high hospitalization cost (4%, p < 0.0001). LOS (-1%, p < 0.0001) and hospitalization cost (-4%, p < 0.0001) decreased yearly. Conclusions: The prevalence of comorbid AF is increasing, particularly in older patients. AF may lead to poorer prognosis, and high-quality intensive care is imperative for this population.

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Section: Discussionmentioning

confidence: 99%

Atrial fibrillation in critically ill patients who received prolonged mechanical ventilation: a nationwide inpatient report

Lin

Han

Guo

et al. 2021

Korean J Intern Med

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“…A meta-analysis has shown that patients with sepsis who developed new-onset AF have higher mortality (11). Studies done in the ICU have shown that critically ill patients with new-onset AF have higher mortality and longer hospital stay (12)(13)(14)(15)(16). AF is also associated with mechanical ventilator weaning failure (17).…”

Section: Discussionmentioning

confidence: 99%

New-onset Atrial Fibrillation In Sepsis No Correlation With Inflammatory Cytokines in Real-life Clinical Setting

Li¹,

Li²,

Chai³

et al. 2020

Preprint

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Background New-onset atrial fibrillation(new-onset AF) is one of the most common tachyarrhythmia in critically ill patients and is associated with increased morbidity and mortality. Unfortunately, risk factors for new-onset AF in sepsis have not been clearly elucidated. This study aims to determine the association of new-onset AF with circulating inflammatory cytokine concentrations. Methods This is a retrospective analysis of the relationship between new-onset AF in sepsis and inflammatory cytokine concentrations. The study included patients with sepsis diagnosed in the Emergency Intensive Care Unit(EICU) of The First Affiliated Hospital of Xinjiang Medical University. This study was conducted on data submitted from June 2016 through May 2019. The patients were classified based on the new-onset AF into Control group(n = 100)、Non New-onset AF in sepsis group(n = 182)、New-onset AF in sepsis group(n = 89). We aimed to investigate whether new-onset AF in sepsis can be explained by increased circulating inflammatory cytokine concentrations. Results Unadjusted analysis of the 371 observations from the retrospective cohort study demonstrated that serum cytokine concentrations do not correlate with new-onset AF in sepsis, despite the fact that cytokines predict mortality and correlate with organ dysfunction and sepsis severity (APACHEⅡ and SOFA scores). On multivariable analysis, the present study shows that hypertension, BMI, fibrinogen and hs-Troponin-T strongly correlated with the new-onset AF in sepsis. Besides, none of the cytokine concentrations correlated with any of the hs-Troponin-T or fibrinogen. Conclusions Our study shows that risk factors for new-onset AF in sepsis are mainly factors that are associated with the pre-admission comorbidity, coagulation, cardiac biomarkers. none of the measured inflammatory cytokines correlates with new-onset AF in sepsis.

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“…NOAF may therefore be a marker of disease severity without an independent influence on mortality [9]. The debate over the attributable mortality of NOAF is ongoing and some studies have not demonstrated an independent association after correcting for disease severity [10,11]. There is however a growing body of evidence demonstrating an association with in-ICU [12,13], hospital [14][15][16][17][18] and long-term [12,14,19] mortality after correcting for confounding variables.…”

Section: Introductionmentioning

confidence: 99%

Hospital outcomes associated with new-onset atrial fibrillation during ICU admission: A multicentre competing risks analysis

Bedford

Gerry

Hatch

et al. 2020

Journal of Critical Care

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New onset atrial fibrillation (NOAF) in critically ill patients has been associated with increased shortterm mortality. Analyses that do not take into account the time-varying nature of NOAF can underestimate its association with hospital outcomes.We investigated the prognostic association of NOAF with hospital outcomes using competing risks methods. Materials and MethodsWe undertook a retrospective cohort study in three general adult intensive care units (ICUs) in the UK from June 2008 to December 2015. We excluded patients with known prior atrial fibrillation or an arrhythmia within four hours of ICU admission.To account for the effect of NOAF on the rate of death per unit time and the rate of discharge alive per unit time we calculated subdistribution hazard ratios (SDHRs). ResultsOf 7541 patients that fulfilled our inclusion criteria, 831 (11.0%) developed NOAF during their ICU admission. NOAF was associated with an increased duration of hospital stay (CSHR 0.68 (95% CI 0.63-0.73)) and an increased rate of in-hospital death per unit time ). This resulted in a strong prognostic association with dying in hospital (adjusted SDHR 2.04 (1.79 -2.32)). NOAF lasting over 30 minutes was associated with increased hospital mortality. ConclusionsUsing robust methods we demonstrate a stronger prognostic association between NOAF and hospital outcomes than previously reported.

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New-onset atrial fibrillation and clinical outcome in non-cardiac intensive care unit patients

Cited by 11 publications

References 21 publications

Atrial fibrillation in critically ill patients who received prolonged mechanical ventilation: a nationwide inpatient report

Atrial fibrillation in critically ill patients who received prolonged mechanical ventilation: a nationwide inpatient report

New-onset Atrial Fibrillation In Sepsis No Correlation With Inflammatory Cytokines in Real-life Clinical Setting

Hospital outcomes associated with new-onset atrial fibrillation during ICU admission: A multicentre competing risks analysis

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