Clinical characteristics and outcomes of septic patients with new-onset atrial fibrillation

J Crit Care. 2008 Dec;23(4):532-6. doi: 10.1016/j.jcrc.2007.09.005.

Abstract

Purpose: No studies have specifically evaluated the incidence or clinical characteristics of atrial fibrillation (AF) in a mixed medical-surgical population of patients with sepsis. We undertook to determine the incidence and clinical course of critically ill septic patients in the intensive care unit (ICU) who developed new-onset AF.

Methods: Retrospective analysis of data collected from the Project IMPACT database on 274 septic patients from July 2003 to December 2004.

Results: Sixteen evaluable septic patients with new-onset AF were identified. Mortality was higher (P = .034) and ICU length of stay (LOS) longer (P = .003) in patients with AF vs those without. Intensive care unit LOS was also longer in the subset of survivors with AF (P = .0001). Hospital LOS was longer among survivors with AF than in survivors without AF (P = .047). Patients with AF had a greater need for mechanical ventilation (P = .0007). Survivors with AF had longer duration of mechanical ventilation than those without AF (P = .006).

Conclusions: Statistically significantly higher mortality was observed in critically ill septic patients with new-onset AF, as were longer duration of mechanical ventilation, ICU, and hospital LOS. Whether the higher incidence of AF in septic patients is a specific risk factor for outcome or an indication of severity of illness remains to be determined.

MeSH terms

  • APACHE
  • Aged
  • Atrial Fibrillation / complications*
  • Atrial Fibrillation / mortality
  • Atrial Fibrillation / therapy
  • Critical Illness
  • Female
  • Humans
  • Intensive Care Units
  • Length of Stay
  • Male
  • Middle Aged
  • Respiration, Artificial
  • Retrospective Studies
  • Sepsis / complications*
  • Sepsis / therapy
  • Treatment Outcome