|
|
Atrial fibrillation (AFIB) in the ICU : incidence, risk factors, and outcomes : the international AFIB-ICU cohort study |
|---|---|
| Author: | Wetterslev, Mik1; Hylander Møller, Morten1; Granholm, Anders1; |
| Organizations: |
1Department of Intensive Care, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark 2Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark 3Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
4Department of Anaesthesiology Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
5Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland 6Department of Intensive Care Medicine, Ministry of National Guard Health Affairs, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia 7Department of Critical Care Medicine, Peking University People’s Hospital, Beijing, China 8Department of Clinical Science and Education, Section of Anaesthesia and Intensive Care, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden 9Department of Intensive Care Medicine, Liverpool Hospital, Liverpool, NSW, Australia 10South Western Clinical School, University of New South Wales, Warwick Farm, NSW, Australia 11Intensive Care Unit, Wellington Hospital, Wellington, New Zealand 12Medical Research Institute of New Zealand, Wellington, New Zealand 13Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland 14Intensive Care Medicine, Department of Acute Medicine and Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland 15Department of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands 16Department of Anaesthesiology, Division of Emergencies and Critical Care, Rikshospitalet, Oslo University Hospital, Oslo, Norway 17Department of Anaesthesia and Intensive Care, Copenhagen University Hospital – North Zealand, Copenhagen, Denmark 18Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark 19Department of Anaesthesia and Intensive Care, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark 20Department of Medicine and Critical Care, Breach Candy Hospital Trust, Mumbai, India 21Department of Pulmonary Medicine, SCB Medical College & Hospital, Cuttack, India 22Department of Anaesthesia and Critical Care, MOSC Medical College, Kolenchery, India 23Department of Critical Care Medicine, Apollo Hospitals, Hyderabad, India 24Department of Critical Care Medicine, Sir H N Reliance Foundation Hospital and Research Centre, Mumbai, India 25Department of Cardiac Anaesthesiology and Critical Care, Tagore Hospital, Jalandhar, India 26Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland 27Department of Anaesthesia and Intensive Care, Oulu University Hospital, Oulu, Finland 28Department of Intensive Care, Tampere University Hospital, Tampere, Finland 29Department of Anesthesia and Intensive Care, Central Finland Central Hospital, Central Finland Health Care District, Jyväskylä, Finland 30Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China 31Department of Intensive Care Medicine, Peking University Shenzhen Hospital, Shenzhen, China 32Department of Critical Care Medicine, Peking University Shenzhen Hospital, Shenzhen, China 33Department of Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, China 34Department of Critical Care Medicine, The Second Hospital, Hebei Medical University, Hebei, China 35Department of Intensive Care Medicine, Tianjin First Center Hospital, Tianjin, China 36Department of Critical Care Medicine, Peking University First Hospital, Beijing, China 37Emergency Intensive Care Unit, Xinjiang Production and Construction Crops 13 div Red Star Hospital 38Department of Anesthesia and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden 39Department of Anaesthesia and Intensive Care, Hudiksvall Hospital, Hudiksvall, Sweden 40Second Department of Anesthesiology and Intensive Care, Medical University of Lublin, Lublin, Poland 41Department of Anesthesiology and Intensive Care, Institute of Medical Sciences, University of Opole, Opole, Poland |
| Format: | article |
| Version: | accepted version |
| Access: | embargoed |
| Persistent link: | http://urn.fi/urn:nbn:fi-fe20230901115135 |
| Language: | English |
| Published: |
Wolters Kluwer,
2023
|
| Publish Date: | 2024-04-20 |
| Description: |
AbstractObjectives: To assess the incidence, risk factors, and outcomes of atrial fibrillation (AF) in the ICU and to describe current practice in the management of AF. Design: Multicenter, prospective, inception cohort study. Setting: Forty-four ICUs in 12 countries in four geographical regions. Subjects: Adult, acutely admitted ICU patients without a history of persistent/permanent AF or recent cardiac surgery were enrolled; inception periods were from October 2020 to June 2021. Intervention: None. Measurements and main results: We included 1,423 ICU patients and analyzed 1,415 (99.4%), among whom 221 patients had 539 episodes of AF. Most (59%) episodes were diagnosed with continuous electrocardiogram monitoring. The incidence of AF was 15.6% (95% CI, 13.8–17.6), of which newly developed AF was 13.3% (11.5–15.1). A history of arterial hypertension, paroxysmal AF, sepsis, or high disease severity at ICU admission was associated with AF. Used interventions to manage AF were fluid bolus 19% (95% CI 16–23), magnesium 16% (13–20), potassium 15% (12–19), amiodarone 51% (47–55), beta-1 selective blockers 34% (30–38), calcium channel blockers 4% (2–6), digoxin 16% (12–19), and direct current cardioversion in 4% (2–6). Patients with AF had more ischemic, thromboembolic (13.6% vs 7.9%), and severe bleeding events (5.9% vs 2.1%), and higher mortality (41.2% vs 25.2%) than those without AF. The adjusted cause-specific hazard ratio for 90-day mortality by AF was 1.38 (95% CI, 0.95–1.99). Conclusions: In ICU patients, AF occurred in one of six and was associated with different conditions. AF was associated with worse outcomes while not statistically significantly associated with 90-day mortality in the adjusted analyses. We observed variations in the diagnostic and management strategies for AF. see all
|
| Series: |
Critical care medicine |
| ISSN: | 0090-3493 |
| ISSN-E: | 1530-0293 |
| ISSN-L: | 0090-3493 |
| Volume: | 51 |
| Issue: | 9 |
| Pages: | 1124 - 1137 |
| DOI: | 10.1097/CCM.0000000000005883 |
| OADOI: | https://oadoi.org/10.1097/CCM.0000000000005883 |
| Type of Publication: |
A1 Journal article – refereed |
| Field of Science: |
3126 Surgery, anesthesiology, intensive care, radiology |
| Subjects: | |
| Copyright information: |
© 2023 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. This is a non-final version of an article published in final form in Wetterslev, Mik MD, PhD1; Hylander Møller, Morten MD, PhD1; Granholm, Anders MD1; Hassager, Christian MD, MedScD2; Haase, Nicolai MD, PhD1; Lange, Theis MSc, PhD3; Myatra, Sheila N. MD4; Hästbacka, Johanna MD, PhD5; Arabi, Yaseen M. MD6; Shen, Jiawei MD7; Cronhjort, Maria MD, PhD8; Lindqvist, Elin MD8; Aneman, Anders MD, PhD9,10; Young, Paul J. MD, PhD11,12; Szczeklik, Wojciech MD, PhD13; Siegemund, Martin MD14; Koster, Thijs MD15; Aslam, Tayyba Naz MD16; Bestle, Morten H. MD, PhD17,18; Girkov, Mia S. MD19; Kalvit, Kushal MD4; Mohanty, Rakesh MD4; Mascarenhas, Joanne MD20; Pattnaik, Manoranjan MD21; Vergis, Sara MD22; Haranath, Sai Praveen MD23; Shah, Mehul MD24; Joshi, Ziyokov MD25; Wilkman, Erika MD, PhD5; Reinikainen, Matti MD, PhD26; Lehto, Pasi MD27; Jalkanen, Ville MD, PhD28; Pulkkinen, Anni MD29; An, Youzhong MD7; Wang, Guoxing MD30; Huang, Lei MD31; Huang, Bin MD32; Liu, Wei MD33; Gao, Hengbo MD34; Dou, Lin MD35; Li, Shuangling MD36; Yang, Wanchun MD37; Tegnell, Emily MD38; Knight, Agnes MD39; Czuczwar, Miroslaw MD, PhD40; Czarnik, Tomasz MD, PhD41; Perner, Anders MD, PhD1; the AFIB-ICU Collaborators. Atrial Fibrillation (AFIB) in the ICU: Incidence, Risk Factors, and Outcomes: The International AFIB-ICU Cohort Study*. Critical Care Medicine 51(9):p 1124-1137, September 2023. | DOI: 10.1097/CCM.0000000000005883. |