Introduction
Methods
Study design and population
Variables and measurements
Exposure and outcomes
Statistical analysis
Results
OverallN = 308 | Non-early groupN = 213 | Early groupN = 95 | P value | |
---|---|---|---|---|
Age, years | 75 (66–82) | 74 (66–81) | 75 (66–83) | 0.495 |
Male, n (%) | 208 (67.5%) | 144 (67.6%) | 64 (67.4%) | 0.967 |
Body mass index, kg/m2 | 22.7 (19.6–25.3) | 22.5 (19.4–25.3) | 22.9 (20.1–25.2) | 0.824 |
Patient category | 0.699 | |||
Non-scheduled surgery, n (%) | 78 (25.3%) | 51 (23.9%) | 27 (28.4%) | |
Scheduled surgery, n (%) | 36 (11.7%) | 25 (11.7%) | 11 (11.6%) | |
Medical, n (%) | 194 (63.0%) | 137 (64.3%) | 57 (60.0%) | |
APACHE II score at ICU admission | 24 (19–30) | 25 (20–30) | 23 (18–27) | 0.039 |
SOFA score at AF onset | 8 (6–11) | 8 (6–12) | 7 (5–9) | 0.009 |
Chronic hemodialysis, n (%) | 17 (5.5%) | 14 (6.6%) | 3 (3.2%) | 0.226 |
CHA2DS2-VASc score | 3 (2–4) | 3 (2–4) | 3 (2–4) | 0.859 |
CHA2DS2-VASc ≥ 2, n (%) | 244 (79.2%) | 169 (79.3%) | 75 (79.0%) | 0.937 |
HAS-BLED bleeding risk score | 2 (1–3) | 2 (1–3) | 2 (1–3) | 0.562 |
HAS-BLED ≥ 3, n (%) | 82 (26.6%) | 58 (27.2%) | 24 (25.3%) | 0.718 |
Infection at AF onset, n (%) | 230 (74.7%) | 157 (73.7%) | 73 (76.8%) | 0.559 |
From ICU admission to AF onset, hours | 28.8 (15.3–113.8) | 27.0 (13.9–115.1) | 31.5 (15.4–113.8) | 0.384 |
Treatment at AF onset | ||||
Mechanical ventilation, n (%) | 212 (68.8%) | 148 (69.5%) | 64 (67.4%) | 0.711 |
Renal replacement therapy, n (%) | 83 (27.0%) | 67 (31.5%) | 16 (16.8%) | 0.008 |
Vasopressors, n (%) | 157 (51.0%) | 107 (50.2%) | 50
(52.6%) | 0.698 |
Inotropes, n (%) | 39 (12.7%) | 25 (11.7%) | 14 (14.7%) | 0.465 |
Overall N = 308 | Non-early group N = 213 | Early group N = 95 | P value | |
---|---|---|---|---|
AF duration, hours | 18.1 (4.2–50.8) | 16.2 (4.3–44.7) | 20.4 (4–64.4) | 0.392 |
AF duration ≥ 48 h, n (%) | 81 (26.3%) | 51 (23.9%) | 30 (31.6%) | 0.160 |
SR restoration before anticoagulation therapya, n (%) | 24 (18.8%) | 16 (48.5%) | 8 (8.4%) | < 0.01 |
AF recurrence, n (%) | 83 (27.0%) | 64 (30.1%) | 19 (20.0%) | 0.066 |
AF at ICU dischargeb, n (%) | 43 (16.0%) | 23 (12.8%) | 20 (22.7%) | 0.037 |
Rhythm control drug, n (%) | 120 (39.0%) | 84 (39.4%) | 36 (37.9%) | 0.800 |
Rate control drug, n (%) | 216 (70.1%) | 150 (70.4%) | 66 (69.5%) | 0.867 |
DC, n (%) | 56 (18.2%) | 44 (20.7%) | 12 (12.6%) | 0.092 |
Initial anticoagulanta | 0.340 | |||
Subcutaneous heparin injection | 31 (24.2%) | 7 (21.2%) | 24 (25.3%) | |
Continuous heparin intravenous injection | 87 (68.0%) | 21 (63.6%) | 66 (69.5%) | |
Warfarin | 2 (1.6%) | 1 (3.0%) | 1 (1.1%) | |
Direct oral anticoagulant | 8 (6.3%) | 4 (12.1%) | 4 (4.2%) | |
Anticoagulants during observation period in ICU | ||||
Anticoagulants from AF onset, ha | 11.4 (0–50.8) | 82.7 (58.3–102.5) | 1.5 (0–20.6) | < 0.01 |
Duration of anticoagulation therapy, ha | 94.2 (44.3–160.6) | 68.2 (30.4–92.4) | 121.5 (65.4–167.6) | < 0.01 |
Anticoagulants at the end of observation period, n (%) | 77 (25.0%) | 24 (11.3%) | 53 (55.8%) | 0.082 |
Mortality or Ischemic stroke during hospital stay, n (%) | 96 (31.2%) | 73 (34.3%) | 23 (24.2%) | 0.078 |
ICU mortality, n (%) | 40 (13.0%) | 33 (15.5%) | 7 (7.4%) | 0.050 |
30-day mortality, n (%) | 65 (21.1%) | 52 (24.4%) | 13 (13.7%) | 0.063 |
Hospital mortality, n (%) | 87 (28.3%) | 65 (30.5%) | 22 (23.2%) | 0.185 |
Ischemic stroke until hospital discharge, n (%) | 11 (3.6%) | 10 (4.7%) | 3 (3.1%) | 0.112 |
During ICU stay n (%) | 6 (2.0%) | 5 (2.4%) | 1 (1.1%) | 0.448 |
After ICU dischargeb, n (%) | 5 (1.9%) | 5 (2.8%) | 0 (0%) | 0.132 |
Bleeding complicationc, n (%) | 27 (8.8%) | 22 (10.3%) | 7 (7.4%) | 0.518 |
Type 1 | 8 | 7 | 1 | |
Type 2 | 7 | 6 | 1 | |
Type 3 | 10 | 8 | 2 | |
Type 4 | 0 | 0 | 0 | |
Type 5 | 2 | 1 | 1 | |
ICU length of stay, days | 8 (5–14) | 8 (6–14) | 8 (5–12) | 0.270 |
Hospital length of stay, days | 32 (17–56) | 30 (16–59) | 33 (19–53) | 0.441 |
Adjusted hazard ratio (95% CI) | P value | |
---|---|---|
Anticoagulation therapy within 48 h from AF onset | 0.77 (0.47–1.23) | 0.281 |
Age (per 5 year old) | 1.02 (0.92–1.15) | 0.664 |
Male | 1.11 (0.68–1.87) | 0.680 |
APACHE II score (per 5 points) | 1.05 (0.91–1.21) | 0.490 |
Infection at AF onset | 1.02 (0.60–1.82) | 0.950 |
CHA2DS2-VASc score | 1.04 (0.88–1.28) | 0.743 |
HAS-BLED bleeding score | 1.13 (0.86–1.47) | 0.394 |
Mechanical ventilation at AF onset | 1.24 (0.75–2.13) | 0.418 |
Renal replacement therapy at AF onset | 1.98 (1.20–3.27) | 0.007 |