The impact of sustained new-onset atrial fibrillation on mortality and stroke incidence in critically ill patients: A retrospective cohort study

Abstract

Purpose: The purpose of the study is to evaluate the impact of sustained new-onset AF on mortality and the incidence of stroke in critically ill non-cardiac surgery patients.

Material and methods: This was a retrospective cohort study of non-cardiac surgery patients with new-onset AF conducted in a general intensive care unit. We compared patients remaining in AF with those restored to sinus rhythm (SR) at 6h after the onset of AF and conducted multivariable logistic regression analysis for in-hospital mortality. We also examined the impact of the cumulative time of AF duration in the first 48h on hospital outcomes.

Results: New-onset AF occurred in 151 of 1718 patients (9%). Patients with sustained AF after 6h (34% of 151 patients included) experienced greater in-hospital mortality than patients with SR at 6h (37% vs. 20%, p=0.033). Multivariable logistic regression analysis confirmed the association between AF at 6h and in-hospital mortality (adjusted odds ratio, 3.14; 95% confidence intervals, 1.28-7.69; p=0.012). Patients with longer AF duration had greater in-hospital mortality (p=0.043) and in-hospital ischemic stroke incidence (p=0.041).

Conclusion: Sustained new-onset AF is associated with poor outcomes.

Keywords: AF at 6h after onset; AF duration; Critically ill patients; Poor outcomes; Sustained new-onset AF.