| Title |
Pre-existing atrial fibrillation and risk of arterial thromboembolism and death in intensive care unit patients: a population-based cohort study
|
|---|---|
| Published in |
Critical Care, December 2015
|
| DOI | 10.1186/s13054-015-1007-5 |
| Pubmed ID | |
| Authors |
Jacob Gamst, Christian Fynbo Christiansen, Bodil Steen Rasmussen, Lars Hvilsted Rasmussen, Reimar Wernich Thomsen |
| Abstract |
Pre-existing atrial fibrillation (AF) may worsen prognosis in patients admitted to the intensive care unit (ICU). In a cohort study (2005-2011) including all patients with first-time ICU admissions in Denmark (n=57,110), we compared patients with and without pre-existing AF and estimated absolute risks and relative risks (RRs) of arterial thromboembolism and death within 30 days and 365 days following admission, using Kaplan-Meier methods and multivariate regression analyses. We analysed the prognostic impact of AF within strata of patient age, sex, coexisting cardiac diseases, and ICU therapies. Among ICU patients, 5065 (9 %) had pre-existing AF. Compared with patients without AF, those with AF were older (median age 75 vs. 62 years) and had more comorbidity. The risk of arterial thromboembolism was 2.8 % in patients with AF and 2.0 % in non-AF patients at 30 days, and 4.3 % and 2.9 %, respectively, at 365 days. Corresponding RRs were 1.41 crude and 1.14 (95 % confidence interval [CI] 0.93-1.40) adjusted at 30 days, and 1.50 crude and 1.20 (95 % CI 1.02-1.41) adjusted at 365 days. Thirty-day mortality was 27 % in patients with pre-existing AF and 16 % in non-AF patients (crude RR 1.67, adjusted RR 1.04, 95 % CI 0.99-1.10). Corresponding mortality estimates at 365 days were 40.9 % and 25.4 %, respectively (crude RR 1.61, adjusted RR 1.03, 95 % CI 1.00-1.07). In stratified analyses, pre-existing AF increased mortality in ICU patients aged <55 years (adjusted RR at 30 days 1.73, 95 % CI 1.29-2.32; adjusted RR at 365 days 1.34, 95 % CI 1.06-1.69) and in ICU patients treated with mechanical ventilation (adjusted RR at 30 days 1.12, 95 % CI 1.05-1.20, adjusted RR at 365 days 1.09, 95 % CI: 1.04-1.15). Analyses stratified by sex and coexisting cardiac diseases yielded adjusted RRs close to 1. In ICU patients, pre-existing AF was associated with modestly increased risk of arterial thromboembolism when adjusted for the substantially higher age and comorbidity levels in patients with AF, whereas there was no overall association with mortality. In ICU patients aged <55 years and in those treated with mechanical ventilation, AF predicted increased mortality. |
X Demographics
The data shown below were collected from the profiles of 21 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 3 | 14% |
| Puerto Rico | 2 | 10% |
| Australia | 1 | 5% |
| South Africa | 1 | 5% |
| United States | 1 | 5% |
| Greece | 1 | 5% |
| Malaysia | 1 | 5% |
| Italy | 1 | 5% |
| Peru | 1 | 5% |
| Other | 2 | 10% |
| Unknown | 7 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 10 | 48% |
| Practitioners (doctors, other healthcare professionals) | 9 | 43% |
| Science communicators (journalists, bloggers, editors) | 2 | 10% |
Mendeley readers
The data shown below were compiled from readership statistics for 39 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 39 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 7 | 18% |
| Other | 4 | 10% |
| Student > Bachelor | 4 | 10% |
| Student > Ph. D. Student | 4 | 10% |
| Student > Postgraduate | 3 | 8% |
| Other | 10 | 26% |
| Unknown | 7 | 18% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 21 | 54% |
| Nursing and Health Professions | 3 | 8% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 3% |
| Arts and Humanities | 1 | 3% |
| Engineering | 1 | 3% |
| Other | 0 | 0% |
| Unknown | 12 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 14. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 August 2015.
All research outputs
#2,538,924
of 25,373,627 outputs
Outputs from Critical Care
#2,200
of 6,554 outputs
Outputs of similar age
#40,710
of 395,408 outputs
Outputs of similar age from Critical Care
#168
of 466 outputs
Altmetric has tracked 25,373,627 research outputs across all sources so far. Compared to these this one has done well and is in the 89th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,554 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.8. This one has gotten more attention than average, scoring higher than 66% of its peers.
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We're also able to compare this research output to 466 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 63% of its contemporaries.