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Eastern Regional Meeting - 2008 Program & Abstracts
Back to 2008 Program
NEW ONSET ATRIAL FIBRILLATION DEVELOPING IN MEDICAL INPATIENTS
S.X. Chen, K. Amir, R. Bobba, E. Arsura, Medicine, Richmond University Medical Center, Staten Island, NY
Purpose of Study: In our retrospective study, we investigated the characteristics, comorbidities and outcomes of patients who develop new onset AF after admission to an Internal Medicine service for acute medical illnesses.
Methods Used: The 24 patients that comprised the study group were admitted with acute medical illnesses and then developed AF during hospitalization in an internal medicine service. We compared the study group with a control group 1 whose admitting diagnosis was new onset AF and a control group 2 who were admitted for acute medical illnesses and never developed AF. We analyzed the clinical characteristics and all-cause mortality rate during the first 30 days, six months and one year after admission. Comparisons between the study group and each control group were performed by two-sample unpaired t-test and Fisher’s exact test. The independent predictors of the mortality were examined by using multiple variables logistic regression analysis.
Summary of Results: The 30 day and 1 year mortality rates in study group were significantly higher than control group 1 (33% vs. 4%, p=0.023 and 62% vs. 8%, p<0.001, respectively), suggesting that acute medical illness increased mortality in this subset of patient population. The highest risk acute medical illnesses were: acute coronary syndrome, respiratory distress and refractory congestive heart failure. The higher one year mortality rate in the study group comparing to control group 2 (62% vs. 29%, p<0.05) indicated that AF is another risk factor for increased all-cause mortality. Our study further demonstrated that acute medical illness and AF both were independent predictors, whereas acute medical illness is the better predictor for patient outcome, as the odds ratios were 4.05 (p=0.023) and 18.33 (p=0.001) for AF and acute medical illnesses, respectively. Troponin I levels were elevated in 46% of patients in study group versus 12% in control group 1 and 42% in control group 2 (p<0.05).
Conclusions: Patients who are admitted with acute medical illnesses and then develop new onset AF have an increased mortality when compared with patients who were admitted solely for new onset AF. Acute medical illness rather than AF plays a more important role on the increased mortality at 30 days and one-year in this subset of patient population. Troponin I elevation also correlates with increased mortality.
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