Mehreen Tooba, Ishtiaq Wasib, Rasheed Ghulam, Kharadi Nusrat, Kiani Sara S, Ilyas Anum, Kaleem Muhammad Ahmed, Abbas Kiran
Department of Critical Care, Shifa International Hospital Islamabad, Islamabad, PAK.
Department of Internal Medicine, Shifa International Hospital Islamabad, Islamabad, PAK.
Cureus. 2021 Oct 13;13(10):e18761. doi: 10.7759/cureus.18761. eCollection 2021 Oct.
Introduction Atrial fibrillation (AF) is one of the most frequent arrhythmias observed in the intensive care unit (ICU). The present study assessed AF as an independent risk factor for mortality among patients in the ICU setting. Methodology A prospective cohort study was conducted at the medical ICU in a tertiary academic medical center from September 2020 to January 2021. All critically ill patients, irrespective of gender, who were admitted for at least two days in the ICU were eligible to partake in the study. Individuals in the cardiovascular surgical ICU and the trauma ICU were not eligible. Demographics, clinical history, the occurrence of AF, fluid input and output, echocardiography, drug history, and hospital mortality were recorded during the first week of admission. Patients were divided into two groups. Results Patients with AF had significantly higher in-hospital mortality, 27 (73%), and longer hospital stays (11.61 ± 7.01) as compared to patients who did not suffer from AF (p<0.0001). The mean length of stay in ICU was 10.32 ± 5.92 and the duration of mechanical ventilation was 7.05 ± 6.16 days in the AF group which was significantly higher than patients who did not have AF (p<0.0001). No significant difference was found in mortality rate between new-onset and recurrent AF among the patients; albeit the latter was higher (60% vs 81.8%, p=0.142). Conclusion The present study indicated that AF was a predictor of mortality hence, associated with poor patient prognosis. The occurrence of AF was associated with high in-hospital mortality and longer hospital stay. Further large-scale studies should be conducted to explore other socio-demographic and clinical risk factors.
引言 心房颤动（AF）是重症监护病房（ICU）中最常见的心律失常之一。本研究评估了AF作为ICU环境中患者死亡的独立危险因素。
方法 2020年9月至2021年1月在一家三级学术医疗中心的医学ICU进行了一项前瞻性队列研究。所有入住ICU至少两天的重症患者，无论性别，均有资格参与本研究。心血管外科ICU和创伤ICU的患者不符合条件。在入院第一周记录人口统计学、临床病史、AF的发生情况、液体出入量、超声心动图、用药史和医院死亡率。患者分为两组。
结果 与未患AF的患者相比，AF患者的院内死亡率显著更高，为27例（73%），住院时间更长（11.61±7.01）（p<0.0001）。AF组的ICU平均住院时间为10.32±5.92天，机械通气时间为7.05±6.16天，显著高于未患AF的患者（p<0.0001）。患者中新发AF和复发AF的死亡率之间未发现显著差异；尽管后者更高（60%对81.8%，p=0.142）。
结论 本研究表明，AF是死亡率的一个预测指标，因此与患者预后不良相关。AF的发生与高院内死亡率和更长的住院时间相关。应进行进一步的大规模研究以探索其他社会人口统计学和临床危险因素。
