Atrial Fibrillation in Critically Ill Patients: Incidence and Outcomes

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2024 Apr 1

PMID 38558719

Authors

Sofia B Paula

Andre Oliveira

Joao Melo E Silva

Andre F Simoes

Joao Goncalves-Pereira

Affiliations

Soon will be listed here.

Abstract

Background: Atrial fibrillation (AF), either chronic or new onset, is common in critically ill patients. Its epidemiology and relationship with clinical outcomes are poorly known.

Objective: To understand the burden of AF in patients admitted to the ICU and its impact on patients' outcomes.

Methods: This is a single-center, retrospective cohort study evaluating all patients with AF admitted to a non-cardiac intensive care unit over the course of 54 months. Clinical outcomes were evaluated in the short (hospital discharge) and long term (two-year follow-up). The hazard ratio (HR) with 95% CI was computed for the whole population as well as for propensity score-matched patients, with or without AF.

Results: A total of 1357 patients were screened (59.1% male), with a mean age of 75 ± 15.2 years, length of intensive care unit stay of 4.7 ± 5.1 days, and hospital mortality of 26%. A diagnosis of AF was found in 215 patients (15.8%), 142 of whom had chronic AF. The hospital all-cause mortality was similar in patients with chronic or new-onset AF (31% vs. 28.8%, p = 0.779). Patients with AF had higher in-hospital, one-year, and two-year crude mortality (30.2% vs. 22.9%, p = 0.024; 47.9% vs. 35.3%, p = 0.001; 52.6% vs. 38.4%, p < 0.001). However, after propensity score matching (N = 213), this difference was no longer significant for in-hospital mortality (OR: 1.17; 95% CI: 0.77-1.79), one-year mortality (OR: 1.38; 95% CI: 0.94-2.03), or two-year mortality (OR: 1.30; 95% CI: 0.89-1.90).

Conclusions: In ICU patients, the prevalence of AF, either chronic or new-onset, was 15.8%, and these patients had higher crude mortality. However, after adjustment for age and severity on admission, no significant differences were found in the short- and long-term mortality.

Citing Articles

Beyond the Beat: A Multifaceted Review of Atrial Fibrillation in Sepsis: Risk Factors, Management Strategies, and Economic Impact.

Ho W, Umais M, Bai M, Dang N, Kumari K, Izhar S Cardiol Res. 2025; 16(1):1-14.

PMID: 39897439 PMC: 11779681. DOI: 10.14740/cr1723.

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