Baumfeld Yael, Novack Victor, Almog Yaniv
Clinical Research Center Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev.
Medical Intensive Care Unit, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev.
Harefuah. 2013 Sep;152(9):520-3, 564.
There is scarcity of data on atrial fibrillation (AF) prevalence and outcomes in critically ill patients admitted to the non-cardiac Intensive Care Unit (ICU).
The purpose of our study was to prospectively assess the incidence, risk factors and prognosis of new onset atrial fibrillation in a medical non-cardiac ICU population.
A prospective single center observational study was conducted in an 8-bed adult Medical Intensive Care Unit (MICU). The patients at the MICU were continuously monitored throughout their stay, once an irregularly irregular rhythm was recorded, a confirmative 12-leads ECG was performed and the incidence, duration of the atrial fibrillation and clinical signs of the patient were logged into the computerized patient file.
A total of 209 patients were included in the study; 23 of these patients developed AF during the hospital stay. Out of the 209 patients, 26% died during the period of hospitalization. There were a few significant differences between the AF group and the non-AF group including age (67 vs. 49, p < 0.001), proportion of Arab Bedouins (4% vs. 28%, p = 0.01), prevalence of coronary heart disease (39% vs. 10%, p < 0.001), paroxysmal atrial fibrillation (52% vs. 3%, p < 0.001), hypertension (70% vs. 31%, p < 0.001 and dyslipidemia 166% vs. 24%, p < 0.001). The APACHE II scores were similar in both groups. In the AF group, there were more patients with sepsis at admission compared with the non-AF group. Age, length of stay, paroxysmal atrial fibrillation (PAF) and dyslipidemia were independent factors for the AF development. AF occurrence adjusted for APACHE-II score was not a significant predictor of death during hospitalization (OR = 1.55, p = 0.38).
The development of AF is more prevalent in patients with PAF. Development of AF was not found to be an independent mortality risk factor.
关于入住非心脏重症监护病房（ICU）的重症患者心房颤动（AF）患病率及转归的数据匮乏。
我们研究的目的是前瞻性评估内科非心脏ICU患者新发心房颤动的发生率、危险因素及预后。
在一个拥有8张床位的成人内科重症监护病房（MICU）进行了一项前瞻性单中心观察性研究。MICU的患者在住院期间持续接受监测，一旦记录到心律不规则，即进行确诊的12导联心电图检查，并将心房颤动的发生率、持续时间及患者的临床症状录入计算机化的患者档案。
共有209例患者纳入研究；其中23例患者在住院期间发生了AF。在这209例患者中，26%在住院期间死亡。AF组与非AF组之间存在一些显著差异，包括年龄（67岁对49岁，p<0.001）、阿拉伯贝都因人的比例（4%对28%，p=0.01）、冠心病患病率（39%对10%，p<0.001）、阵发性心房颤动（52%对3%，p<0.001）、高血压（70%对31%，p<0.001）和血脂异常（166%对24%，p<0.001）。两组的急性生理与慢性健康状况评分系统（APACHE II）评分相似。与非AF组相比，AF组入院时脓毒症患者更多。年龄、住院时间、阵发性心房颤动（PAF）和血脂异常是AF发生的独立因素。校正APACHE-II评分后的AF发生情况并非住院期间死亡的显著预测因素（比值比=1.55，p=0.38）。
PAF患者中AF的发生更为普遍。AF的发生并非独立的死亡危险因素。
