Risk of incident atrial fibrillation after a prior critical illness: A retrospective cohort study

  • Wei-Syun Hu
    Corresponding author at: Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yuh-Der Road, Taichung 40447, Taiwan.
    School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan

    Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan
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  • Cheng-Li Lin
    Management Office for Health Data, China Medical University Hospital, Taichung 40447, Taiwan
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Published:September 19, 2018DOI:


      • This is a nationwide cohort study.
      • Propensity matching and competing risk methods were used.
      • Risk of AF after a prior diagnosis of critical condition was noted.



      This investigation aimed at assessing the issue of incident atrial fibrillation (AF) associated with acute critical illness.


      The study came from Taiwan and used that nation's Longitudinal Health Insurance Database 2000. Using propensity score matching, multivariable adjustment and competing risk methods, the correlations between the new-onset AF and critical illness (septicemia/septic shock, acute myocardial infarction【AMI】, hemorrhagic stroke and ischemic stroke) were investigated.


      This study consisted of 46470 patients in the critical illness cohort, 618998 persons in the general population cohort. Additionally, 37,060 critically ill patients were matched with 37060 control patients based on propensity score methods. Compared with general population cohort, patients with septicemia/septic shock were 3.12-fold more likely to develop AF (95% confidence interval 【CI】 = 2.88–3.39), followed by patients with ischemic stroke (adjusted hazard ratio【aHR】 = 1.96, 95% CI = 1.80–2.14), patients with AMI (aHR = 1.62, 95% CI = 1.32–2.00) and patients with hemorrhagic stroke (aHR = 1.46, 95% CI = 1.13–1.88). In addition, after controlling for the confounding factors and the competing risk of death, the critical illness cohort still exhibited a significantly higher risk of AF than the general population cohort (adjusted subhazard ratio [aSHR] = 2.66, 95% CI = 2.49–2.84).


      Our study explored incident AF among patients with critical illness in their medical history. Patients with septicemia/septic shock were at the highest risk of developing new-onset AF among these critically ill patients.


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