The impact of sustained new-onset atrial fibrillation on mortality and stroke incidence in critically ill patients: A retrospective cohort study

Purpose: The purpose of the study is to evaluate the impact of sustained new-onset AF on mortality and the incidence of stroke in critically ill non-cardiac surgery patients. Material and methods: This was a retrospective cohort study of non-cardiac surgery patients with new-onset AF conducted in a general intensive care unit. We compared patients remaining in AF with those restored to sinus rhythm (SR) at 6 h after the onset of AF and conducted multivariable logistic regression analysis for in-hospital mortality. We also examined the impact of the cumulative time of AF duration in the first 48 h on hospital outcomes. Results: New-onset AF occurred in 151 of 1718 patients (9%). Patients with sustained AF after 6 h (34% of 151 patients included) experienced greater in-hospital mortality than patients with SR at 6 h (37% vs. 20%, p = 0.033). Multivariable logistic regression analysis confirmed the association between AF at 6 h and in-hospital mortality (adjusted odds ratio, 3.14; 95% confidence intervals, 1.28–7.69; p = 0.012). Patients with longer AF duration had greater in-hospital mortality (p = 0.043) and in-hospital ischemic stroke incidence (p = 0.041). Conclusion: Sustained new-onset AF is associated with poor outcomes.