Predictors for sustained new-onset atrial fibrillation in critically ill patients: a retrospective observational study
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Although new-onset atrial fibrillation (AF) is frequently observed in the intensive care unit (ICU), the incidence and predictors for sustained new-onset AF have not been investigated, except for cardiac surgery patients. We have evaluated potential predictors for sustained new-onset AF in a mixed ICU.
In this retrospective observational study, we screened non-cardiac surgery patients who were admitted to the ICU between January 2010 and December 2013 and had been hospitalized for > 24 h in the ICU. We collected information about heart rhythm 6 h after the onset of AF. We compared detailed patient characteristics between patients with sinus rhythm (SR) and those with sustained AF at 6 h after the onset of AF. Additionally, we applied variable selection using backward elimination based on Akaike’s Information Criterion (AIC). Calibration was performed based on the Hosmer–Lemeshow test.
New-onset AF occurred in 151 of 1718 patients and 99 patients converted to SR at 6 h. Backward elimination identified predictors as follows (AIC = 175.3): CHADS2 score, elective surgery, infection on ICU admission, serum potassium > 4.0 mmol/L, male sex, mechanical ventilation, and diagnostic grouping. The model showed good calibration for sustenance of AF at 6 h after the onset using the Hosmer–Lemeshow Chi-square value of 4.36 (degrees of freedom = 4, p = 0.360) indicating a good fit.
These predictors might be useful in future interventional studies to identify patients who are likely to sustain new-onset AF.
KeywordsPredictors Sustained new-onset AF Critically ill patients AF at 6 h after onset Sinus rhythm
Departmental funding only.
TY extracted the data, analyzed the data, and wrote the first draft of the manuscript. SU designed the study, supervised the analysis of the data, and critically revised the manuscript. TY extracted the data, interpreted the data and critically revised the manuscript. TF was in charge of statistical analysis and critically revised the manuscript. MT interpreted the data and critically revised the manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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