October 15, 2015

Risk of death in the ICU

The irregular heart rhythm atrial fibrillation increases the risk of death in patients in the intensive care unit.

Atrial fibrillation (AF), an irregular and often rapid heart rate that can cause poor blood flow to the body, is an independent predictor of mortality in critically ill patients.

That’s the conclusion of a study of 1,770 critically ill adults admitted to medical and surgical intensive care units at Vanderbilt University Hospital, the largest prospective study of AF in critical illness.

Ciara Shaver, M.D., Ph.D., and colleagues found that AF was associated with an increased risk of in-hospital mortality independent of the severity of critical illness, underlying cardiac risk factors or the presence of sepsis.

Thirty percent of the patients who had any AF during the four-day study period died during hospitalization, compared with 17 percent of patients with no AF, the researchers reported this month in the journal Critical Care Medicine.

A greater understanding of the underlying pathophysiology of AF during critical illness is warranted, they wrote, in order to prevent and treat AF in critically ill patients and reduce patient mortality.

The research was supported in part by National Institutes of Health grants HL087738, HL092217 and HL103836.

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