Farooqui Arafat A, Mazhar Uddin Syed M, Maheshwari Sanjay K, Clements Kevin, Ashraf Rabiah, Keith Jay, Sharma Neha, Bilal Haris, Saleem Naira, Shetty Vijay S
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY 11219, USA.
Department of Cardiology, Maimonides Medical Center, Brooklyn, NY 11219, USA.
J Community Hosp Intern Med Perspect. 2025 Mar 7;15(2):25-32. doi: 10.55729/2000-9666.1467. eCollection 2025.
To evaluate different factors precipitating new onset atrial fibrillation (AF) in hospitalized patients and their effect on in-patient mortality.
Retrospective cross-sectional study.
Urban tertiary care center in New York City.
Primary outcomes:Determine different factors precipitating new onset atrial fibrillation in hospitalized patients and their effect on in-patient mortality.Secondary outcomes:Determine the duration of hospital stay after admission precipitating new onset atrial fibrillation and its effect on mortality.Evaluate different factors in COVID-19 patients with new onset atrial fibrillation.
Out of 464 patients; 62.3 % were males and 37.72 % were females. Evaluation of patients before developing new onset AF showed that 75.86 % had hypertension, 41.38 % had heart failure and 42.67 % had ischemic heart disease (IHD). Younger patients were noted to be treated with more rhythm control as compared to rate control (52.38 % vs 38.1 %) for their management while opposite was observed with patients >50 years of age (70.88 % vs 52.6 %; rate control vs rhythm control respectively). In terms of mortality, female gender ( = 2.63, 95 % CI: 1.03-6.94, = 0.045), presence of infection ( = 6.00, 95 % CI: 2.23-18.08, <0.001), use of vasopressors ( = 6.71, 95 % CI: 2.58-19.42, < 0.001), and a history of CVA ( = 6.98, 95 % CI: 1.99-24.58, = 0.002) all significantly increased the odds for mortality. Majority of the patients; 54.31 %, developed new onset AF after the third day of admission but it did not increase the mortality (OR 0.93, 95 % CI 0.37-2.45, p = 0.884). Majority of the patients (67 %) had enlarged left atrium (>35 ml/m). However, it was not associated with higher mortality (OR 0.53, 95 % CI 0.19-1.48, p = 0.223). Patients that were tested positive for COVID-19 were more likely to have sepsis (75 % vs 31.46 %, < 0.001).
This study finds that four factors i.e., female gender, presence of infection, use of vasopressors, and a history of CVA all precipitate new onset atrial fibrillation with resultant increase in mortality during the same admission. Study concludes that longer hospital stay of more than three days increases the likelihood of developing new onset atrial fibrillation without increasing the mortality. Study found that patients who were positive forCOVID-19 were more likely to have sepsis.
评估住院患者新发房颤（AF）的不同诱发因素及其对住院死亡率的影响。
回顾性横断面研究。
纽约市的城市三级医疗中心。
主要结局：确定住院患者新发房颤的不同诱发因素及其对住院死亡率的影响。次要结局：确定新发房颤入院后的住院时间及其对死亡率的影响。评估新冠病毒病（COVID-19）患者新发房颤的不同因素。
在464例患者中，62.3%为男性，37.72%为女性。对新发房颤患者发病前的评估显示，75.86%患有高血压，41.38%患有心力衰竭，42.67%患有缺血性心脏病（IHD）。与老年患者相比，年轻患者在治疗中更多采用节律控制而非心率控制（分别为52.38%对38.1%），而50岁以上患者情况相反（分别为70.88%对52.6%；心率控制对节律控制）。在死亡率方面，女性（=2.63，95%CI：1.03 - 6.94，=0.045）、存在感染（=6.00，95%CI：2.23 - 18.08，<0.001）、使用血管升压药（=6.71，95%CI：2.58 - 19.42，<0.001）和有卒中史（=6.98，95%CI：1.99 - 24.58，=0.002）均显著增加死亡几率。大多数患者（54.31%）在入院第三天后出现新发房颤，但这并未增加死亡率（OR 0.93，95%CI 0.37 - 2.45，p = 0.884）。大多数患者（67%）左心房增大（>35 ml/m）。然而，这与较高死亡率无关（OR 0.53，95%CI 0.19 - 1.48，p = 0.223）。新冠病毒病检测呈阳性的患者更易发生脓毒症（75%对31.46%，<0.001）。
本研究发现，女性、存在感染、使用血管升压药和有卒中史这四个因素均会诱发新发房颤，并导致同一住院期间死亡率增加。研究得出结论，住院时间超过三天会增加新发房颤的发生可能性，但不会增加死亡率。研究发现，新冠病毒病检测呈阳性的患者更易发生脓毒症。
