New-onset atrial fibrillation and associated outcomes and resource use among critically ill adults-a multicenter retrospective cohort study

Autor: Shannon M. Fernando, F. Daniel Ramirez, Pietro Di Santo, Peter Tanuseputro, Rebecca Mathew, Benjamin Hibbert, Morten Hylander Møller, Bram Rochwerg, Laveena Munshi, Allan J. Walkey, Trevor Simard, Kwadwo Kyeremanteng
Rok vydání: 2019
Předmět:
Male
Time Factors
Letter
Critical Care and Intensive Care Medicine
Logistic regression
law.invention
Cohort Studies
0302 clinical medicine
law
Risk Factors
Atrial Fibrillation
Outcome Assessment
Health Care
Odds Ratio
Medicine
Registries
Outcome Assessment
Health Care/statistics & numerical data
Critical Illness/epidemiology
Aged
80 and over
Ontario
education.field_of_study
Registries/statistics & numerical data
lcsh:Medical emergencies. Critical care. Intensive care. First aid
Atrial fibrillation
Middle Aged
Intensive care unit
Intensive Care Units
Cohort
Female
Atrial Fibrillation/complications
medicine.medical_specialty
Critical Illness
Population
Statistics
Nonparametric
03 medical and health sciences
Resource utilization
Humans
education
Aged
Retrospective Studies
Intensive Care Units/organization & administration
business.industry
030208 emergency & critical care medicine
Retrospective cohort study
lcsh:RC86-88.9
Odds ratio
medicine.disease
Confidence interval
Costs
Critical care
Logistic Models
030228 respiratory system
Emergency medicine
business
Zdroj: Critical Care
Critical Care, Vol 24, Iss 1, Pp 1-10 (2020)
Fernando, S M, Mathew, R, Hibbert, B, Rochwerg, B, Munshi, L, Walkey, A J, Møller, M H, Simard, T, Di Santo, P, Ramirez, F D, Tanuseputro, P & Kyeremanteng, K 2020, ' New-onset atrial fibrillation and associated outcomes and resource use among critically ill adults : a multicenter retrospective cohort study ', Critical Care, vol. 24, 15 . https://doi.org/10.1186/s13054-020-2730-0
ISSN: 1466-609X
DOI: 10.1186/s13054-020-2730-0
Popis: Background New-onset atrial fibrillation (NOAF) is commonly encountered in critically ill adults. Evidence evaluating the association between NOAF and patient-important outcomes in this population is conflicting. Furthermore, little is known regarding the association between NOAF and resource use or hospital costs. Methods Retrospective analysis (2011–2016) of a prospectively collected registry from two Canadian hospitals of consecutive ICU patients aged ≥ 18 years. We excluded patients with a known history of AF prior to hospital admission. Any occurrence of atrial fibrillation (AF) was prospectively recorded by bedside nurses. The primary outcome was hospital mortality, and we used multivariable logistic regression to adjust for confounders. We used a generalized linear model to evaluate contributors to total cost. Results We included 15,014 patients, and 1541 (10.3%) had NOAF during their ICU admission. While NOAF was not associated with increased odds of hospital death among the entire cohort (adjusted odds ratio [aOR] 1.02 [95% confidence interval [CI] 0.97–1.08]), an interaction was noted between NOAF and sepsis, and the presence of both was associated with higher odds of hospital mortality (aOR 1.28 [95% CI 1.09–1.36]) than either alone. Patients with NOAF had higher total costs (cost ratio [CR] 1.09 [95% CI 1.02–1.20]). Among patients with NOAF, treatment with a rhythm-control strategy was associated with higher costs (CR 1.24 [95% CI 1.07–1.40]). Conclusions While NOAF was not associated with death or requiring discharge to long-term care among critically ill patients, it was associated with increased length of stay in ICU and increased total costs.
Databáze: OpenAIRE
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