Prevalence and Risk Factors of New-Onset Atrial Fibrillation and Its Role in the Prognosis of Critically Ill Patients

authors:

avatar Saeed Golami Garab 1 , avatar Mohammad Javad Abdolhay 1 , avatar Alireza Gandomi-Mohammadabadi 2 , avatar Javad Balasi 2 , avatar Mohammad Amin Abbasi 1 , *

Firoozabadi Clinical Research Development Unit (FCRDU), Iran University of Medical Sciences (IUMS), Tehran, Iran
Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

How To Cite Golami Garab S, Abdolhay M J, Gandomi-Mohammadabadi A, Balasi J, Abbasi M A. Prevalence and Risk Factors of New-Onset Atrial Fibrillation and Its Role in the Prognosis of Critically Ill Patients. Int J Cardiovasc Pract. 2021;6(1):e131478. https://doi.org/10.5812/intjcardiovascpract-131478.

Abstract

Introduction: Atrial fibrillation (AF) is the most prevalent dysrhythmia in the intensive care unit (ICU). This study aimed to assess the prevalence, clinical outcomes, and risk factors of new-onset AF in patients admitted to ICU, concerning mortality and length of stay.
Methods: This cohort study consisted of patients above 18 years old admitted to the ICU of Firoozabadi hospital in 2019_2020. New-onset AF diagnosis was confirmed by ECG electrographic changes watched by cardiologists in 24 hours for each patient. Patients were divided into two groups: without new-onset AF [171 patients, 54.4% men, age: 65.09 (18–97) years] and with new-onset AF [23 patients, 52.2% men, age: 79 (55–95) years]. Clinical and laboratory features, including neutrophil-tolymphocyte ratio (NLR) and platelet-to- lymphocyte ratio (PLR), were compared between the groups.
Results: Among 194 patients, 118 (61%) were survivors, and 76 (39%) were nonsurvivors. Twenty-three patients (11.9%) developed new-onset AF. The AF group was significantly older than those in the no AF group (AF vs. no AF: 79 ± 11.5 years vs. 65 ± 20 years, P = 0.02). ICU survivors had a significantly shorter ICU stay than nonsurvivors (6 ± 0.5 days versus 13.6 ± 1.9 days, P < 0.001). Also, patients with new-onset AF had longer ICU stay (AF vs. no AF: 15.5 ± 10.9 days vs. 7.8 ± 10.6 days, P = 0.02). Patients who developed new-onset AF in the ICU had not greater in-hospital mortality (AF vs. no AF: 16.4% vs. 9.6%, P > 0.05). The NLR of AF and no AF subjects were 16.7 ± 12.6 and 11.6. ± 14.9, respectively (P = 0.008). There was no significant difference between the PLR of the AF group (284.6 ± 211.8) and no AF group (264.8 ± 204.8) (P = 0.7).
Conclusions: Atrial fibrillation may not be independently associated with hospital mortality. NLR is a predictor of new-onset AF in critically ill patients.

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