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Prognostic impact of sustained new-onset atrial fibrillation in critically ill patients.
- Source :
- Intensive Care Medicine; Jan2020, Vol. 46 Issue 1, p27-35, 9p, 4 Charts, 1 Graph
- Publication Year :
- 2020
-
Abstract
- <bold>Purpose: </bold>The development of new-onset atrial fibrillation (AF) in critically ill patients may be associated with poor outcomes. However, it is unknown whether sustained new-onset AF contributes to worse outcome. The aim of this study was to assess whether sustained new-onset AF is associated with stroke and death and to look for a possible dose-response relationship between AF duration and death.<bold>Methods: </bold>In a prospective cohort study conducted in 32 intensive care units in Japan from 2017 to 2018, we enrolled adult patients with new-onset AF. We compared patients with AF duration longer than 48 h with those with AF duration shorter than 48 h. To assess a dose-response relationship between AF duration and hospital mortality, we conducted landmark analysis and time-dependent Cox regression analysis.<bold>Results: </bold>Among a total of 423 new-onset AF patients, hospital mortality was 25%, and the incidence of in-hospital stroke was 4.6%. AF duration longer than 48 h was not independently associated with hospital mortality (adjusted odds ratio: 1.52; 95% Confidence Interval: 0.87-2.64). The incidence of in-hospital stroke was 7.6% in patients with AF duration longer than 48 h and 3.8% in those with AF duration shorter than 48 h (p = 0.154). When analyzing time more continuously, we observed a time-dependent association between AF duration and hospital mortality (p = 0.005 by landmark analysis and p = 0.019 by Cox analysis).<bold>Conclusions: </bold>Sustained new-onset AF was time-dependently associated with hospital mortality in ICU patients, albeit with some uncertainty since AF duration longer than 48 h was not independently associated with in-hospital death or stroke. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 03424642
- Volume :
- 46
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Intensive Care Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 141150472
- Full Text :
- https://doi.org/10.1007/s00134-019-05822-8