Chen Sydney X, Amir Khalil A, Bobba Ravi K, Arsura Edward L
Department of Medicine, Richmond University Medical Center, Staten Island, New York 10310, USA.
Am J Med Sci. 2009 Mar;337(3):169-72. doi: 10.1097/MAJ.0b013e3181833859.
The outcome of patients who develop new onset atrial fibrillation (AF) after admission to an Internal Medicine service for acute medical illnesses is unknown.
In a retrospective review, we compared patients in the study group: patients who were admitted to hospital for acute medical illnesses and subsequently developed new onset AF during hospitalization, with a control group 1: patients whose admitting diagnosis was new onset AF and a control group 2: patients who were admitted for acute medical illnesses and never developed AF. We analyzed clinical characteristics and all-cause mortality rate during the first 30 days, 6 months, and 1 year after admission.
The 1-year mortality rates in study group were significantly higher than control group 1 (62% versus 8%, P < 0.001) and control group 2 (62% versus 29%, P < 0.05). These results suggest that AF and acute medical illness both are risk factors for increased mortality. The odds ratios were 4.05 (P = 0.023) and 18.33 (P = 0.001) for AF and acute medical illnesses, respectively, indicating that acute medical illness is the better predictor for mortality. Troponin I levels were elevated in 46% of patients in study group versus 12% in control group 1 and 42% in control group 2 (P < 0.05).
Medical inpatients who develop new onset AF during hospitalization for acute medical illnesses have an increased mortality when compared with patients who were admitted solely for new onset AF. Acute medical illness rather than AF plays a more important role on the increased mortality in this subset of patient population.
内科收治急性内科疾病患者后新发房颤（AF）的患者结局尚不清楚。
在一项回顾性研究中，我们将研究组患者（因急性内科疾病入院且住院期间随后新发房颤的患者）与对照组1（入院诊断为新发房颤的患者）和对照组2（因急性内科疾病入院且从未发生房颤的患者）进行比较。我们分析了入院后第30天、6个月和1年的临床特征和全因死亡率。
研究组的1年死亡率显著高于对照组1（62%对8%，P<0.001）和对照组2（62%对29%，P<0.05）。这些结果表明房颤和急性内科疾病都是死亡率增加的危险因素。房颤和急性内科疾病的优势比分别为4.05（P=0.023）和18.33（P=0.001），表明急性内科疾病是死亡率更好的预测指标。研究组46%的患者肌钙蛋白I水平升高，而对照组1为12%，对照组2为42%（P<0.05）。
因急性内科疾病住院期间新发房颤的内科住院患者与仅因新发房颤入院的患者相比死亡率增加。在这部分患者群体中，急性内科疾病而非房颤在死亡率增加方面起更重要作用。
