Highlights
- •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.
Abstract
Objective
This investigation aimed at assessing the issue of incident atrial fibrillation (AF)
associated with acute critical illness.
Methods
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.
Results
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).
Conclusions
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.
Keywords
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Article info
Publication history
Published online: September 19, 2018
Accepted:
September 3,
2018
Received in revised form:
August 18,
2018
Received:
April 28,
2018
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
