Abstract
Background: Atrial fibrillation is the most common cardiac arrhythmia in emergency departments and intensive care units.
Objectives: We aimed to characterize critical care patients with paroxysmal atrial fibrillation who are at a higher risk for mortality or readmission.
Methods: A secondary analysis was conducted on data from a large sample of patients admitted (January 2010 to December 2015) to the emergency department of a hospital who had blood electrolytes measured. In total, data from 520 individuals with paroxysmal atrial fibrillation were analyzed. A clustering algorithm was used to identify patients with similar electrolyte profile.
Results: Two clusters of patients were identified (N1 = 163, N2 = 357) with significantly different proportions of the poor outcome, 57 (35.0%) vs. 66 (18.5%), respectively (P<0.001). The high-risk cluster included older patients [74.4 (12.8) vs. 66.6 (14.7) years, P<0.001] with mean serum glucose higher than those in the low-risk cluster. Moreover, the high-risk group had lower concentrations of serum sodium, potassium, calcium, phosphorus, and magnesium (all P<0.001). Endocrine and circulatory comorbidities were also more common in the high-risk cluster (both P ≤0.001). Our results did not show any significant difference in the female sex ratio between the two clusters [81 (49.7%) vs. 152 (42.6%), P = 0.156].
Conclusion: Based on serum electrolyte concentrations, there are two clusters with different prognoses in patients with paroxysmal atrial fibrillation. The high-risk cluster is older with more comorbidities and higher serum glucose levels and lower serum concentrations of sodium, potassium, calcium, phosphorus, and magnesium.
Copyright
© 2024, Shahid Beheshti University of Medical Sciences. This open-access article is available under the Creative Commons Attribution-NonCommercial 4.0 (CC BY-NC 4.0) International License (https://creativecommons.org/licenses/by-nc/4.0/), which allows for the copying and redistribution of the material only for noncommercial purposes, provided that the original work is properly cited.