Determinants of new-onset atrial fibrillation in a multidisciplinary critical care unit

Abstract

Background: The presence of New-onset Atrial Fibrillation (NOAF) during critical illness increases morbidity, mortality, and hospital costs, as well as the incidence of complications such as heart failure and thromboembolic disorders. We aimed to determine the incidence and the risk factors associated with NOAF in Intensive Care Units (ICU). Material and Methods: A nested case control study of patients admitted to ICU was conducted to determine the risk factors associated with NOAF. Occurrence of potential risk factors were noted once in eight hours. Frequency, percentage, and odds ratio were calculated. Multiple logistic regression was done to find the risk factors associated with NOAF. Results: We followed up 271 individuals of both genders, among whom 29 cases of new onset of AF were observed (10.7%). The risk of getting NOAF was higher for those who were on renal replacement therapy (OR: 7.9 (95% CI: 3.2-19.2)), suspected sepsis (OR: 4.2 (95% CI: 1.7-10.2)) and had hypokalemia (OR: 4 (95% CI: 1.2-12.9)). Conclusion: Prompt diagnosis and treatment of hypokalaemia and sepsis may significantly reduce the risk of NOAF in ICU. Other independent risk factors were suspected sepsis and renal replacement therapy.

Keywords

• atrial fibrillation
• critical care
• new-onset atrial fibrillation
• hypokalaemia
• sepsis