Atrial Fibrillation and Mortality in Critically Ill Patients: A Retrospective Study

Gupta, Sachin; Tiruvoipati, Ravindranath; Green, Cameron

doi:10.4037/ajcc2015319

Cited by 16 publications

(18 citation statements)

References 24 publications

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“…By adjusting for clinical confounders, the present study clearly shows the independent association of AFib with increased risk of in-hospital death. These results are in contrast with data from a retrospective single-centre study by Gupta et al and a prospective multi-centre study by Annane et al, which both failed to show independent association of AFib with increased in-hospital mortality 8,9 .…”

Section: Discussioncontrasting

confidence: 99%

“…Two very recent studies provided opposing results. Gupta et al failed to show independent association between the presence of AFib (new-onset or recurrent) during critical illness and in-hospital mortality 9 The primary aim of this French and euRopean Outcome reGistry in Intensive Care Unit (FROG-ICU) sub-study was to test the hypothesis that new-onset AFib during critical illness is independently associated with in-hospital and post-ICU mortality.…”

Section: Introductionmentioning

confidence: 97%

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New-onset atrial fibrillation in critically ill patients and its association with mortality: A report from the FROG-ICU study

Arrigo

Ishihara

Féliot

et al. 2018

International Journal of Cardiology

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 97%

New-onset atrial fibrillation in critically ill patients and its association with mortality: A report from the FROG-ICU study

Arrigo

Ishihara

Féliot

et al. 2018

International Journal of Cardiology

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“…The percentage of patients that left the ICU in sinus rhythm is comparable to another study that found 82% of the patients in sinus rhythm 6. In-hospital mortality in our study population was comparable to results found in other ICU studies 12 18 19. Also, overall mortality was comparable to mortality found in other studies.…”

Section: Discussionsupporting

confidence: 89%

“…This illustrates the lack of evidence and guidance on treatment in this specific patient group of critically ill new-onset AF patients. Other studies also reported percentages of 70.4% and 69.6% for AF patients that did not receive anticoagulation at the ICU 3 12…”

Section: Discussionmentioning

confidence: 96%

“…New onset of AF can be self-terminating in the critically ill phase though it could also be provocative for developing permanent AF. Evidence suggests that new-onset AF is associated with a higher mortality in critically ill patients admitted to the ICU 9 11 12. Since there is no clear consensus on which anticoagulative treatment is most appropriate to treat new-onset AF in critically ill patients, we aimed to determine the incidence of new-onset AF in a retrospective cohort study and analysed the anticoagulation strategies that were initiated on the ICU of our teaching hospital.…”

Section: Introductionmentioning

confidence: 99%

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Incidence, treatment and mortality of new-onset atrial fibrillation patients at the intensive care unit

et al. 2020

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ObjectiveCritically ill patients admitted to the intensive care unit (ICU) often develop atrial fibrillation (AF), with an incidence of around 5%. Stroke prevention in AF is well described in clinical guidelines. The extent to which stroke prevention is prescribed to ICU patients with AF is unknown. We aimed to determine the incidence of new-onset AF and describe stroke prevention strategies initiated on the ICU of our teaching hospital. Also, we compared mortality in patients with new-onset AF to critically ill patients with previously diagnosed AF and patients without any AF.MethodsThis study was a retrospective cohort study including all admissions to the ICU of the Martini Hospital (Groningen, The Netherlands) in the period 2011 to 2016. Survival analyses were performed using these real-world data.ResultsIn total, 3334 patients were admitted to the ICU, of whom 213 patients (6.4%) developed new-onset AF. 583 patients (17.5%) had a previous AF diagnosis, the other patients were in sinus rhythm. In-hospital mortality and 1-year mortality after hospital discharge were significantly higher for new-onset AF patients compared with patients with no history of AF or previously diagnosed AF. At hospital discharge, only 56.3% of the new-onset AF-patients eligible for stroke prevention received an anticoagulant. Anticoagulation was not dependent on CHA2DS2-VASc score or other patient characteristics. An effect of anticoagulative status on mortality was not significant.ConclusionAF is associated with increased mortality in critically ill patients admitted to the ICU. More guidance is needed to optimise anticoagulant treatment in critically ill new-onset AF patients.

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A Predictive Nomogram of In‐Hospital Mortality After 48 h for Atrial Fibrillation Patients in the Coronary Care Unit

Wang,

Liu,

Jin

et al. 2024

Clinical Cardiology

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BackgroundPatients with atrial fibrillation (AF) suffer a higher risk of death, and it is necessary to develop prediction tools for mortality risk in critically ill patients with AF. This study aimed to develop a novel predictive nomogram of in‐hospital mortality after 48 h in the coronary care unit (CCU) for patients with AF.MethodsWe collected information on CCU patients with AF from the “Medical Information Mart for Intensive Care‐III” database and developed a nomogram model for predicting the all‐cause mortality risk after 48 h in the hospital. Key variables were selected by univariate logistic and least absolute shrinkage and selection operator regression. The independent predictors with p < 0.05 were screened out by multivariate logistic regression. A predictive nomogram was constructed using these independent predictors, and the model calibration and discrimination were evaluated.ResultsThis study finally enrolled 1248 CCU patients with AF, and the in‐hospital mortality was 17% (209/1248). The predictive nomogram was constructed by 13 selected independent predictors, including age, smoking status, acute kidney injury, chronic obstructive pulmonary disease, ventricular arrhythmia, shock, urea, red cell distribution width, leucocytosis, continuous renal replacement therapy, continuous positive airway pressure, anticoagulation, and heart rate. The area under the curve of the nomogram was 0.803 (95% confidence interval 0.771–0.835). The nomogram was verified to have good accuracy and calibration.ConclusionsThis study developed a novel nomogram containing age, acute kidney injury, and heart rate that can be a good predictor of potential in‐hospital mortality after 48 h in CCU patients with AF.

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Atrial Fibrillation and Mortality in Critically Ill Patients: A Retrospective Study

Cited by 16 publications

References 24 publications

New-onset atrial fibrillation in critically ill patients and its association with mortality: A report from the FROG-ICU study

New-onset atrial fibrillation in critically ill patients and its association with mortality: A report from the FROG-ICU study

Incidence, treatment and mortality of new-onset atrial fibrillation patients at the intensive care unit

A Predictive Nomogram of In‐Hospital Mortality After 48 h for Atrial Fibrillation Patients in the Coronary Care Unit

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