ヨシダ タクオ
  吉田 拓生
   所属   医学部 医学科(東京女子医科大学病院)
   職種   講師
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Predictors for sustained new-onset atrial fibrillation in critically ill patients: a retrospective observational study.
掲載誌名 正式名:Journal of anesthesia
略  称:J Anesth
ISSNコード:14388359/09138668
掲載区分国外
巻・号・頁 32(5),pp.681-687
著者・共著者 Yokota Taisuke, Uchino Shigehiko, Yoshida Takuo, Fujii Tomoko, Takinami Masanori
発行年月 2018/10
概要 PURPOSE:Although new-onset atrial fibrillation (AF) is frequently observed in the intensive care unit (ICU), the incidence and predictors for sustained new-onset AF have not been investigated, except for cardiac surgery patients. We have evaluated potential predictors for sustained new-onset AF in a mixed ICU.METHODS:In this retrospective observational study, we screened non-cardiac surgery patients who were admitted to the ICU between January 2010 and December 2013 and had been hospitalized for > 24 h in the ICU. We collected information about heart rhythm 6 h after the onset of AF. We compared detailed patient characteristics between patients with sinus rhythm (SR) and those with sustained AF at 6 h after the onset of AF. Additionally, we applied variable selection using backward elimination based on Akaike's Information Criterion (AIC). Calibration was performed based on the Hosmer-Lemeshow test.RESULTS:New-onset AF occurred in 151 of 1718 patients and 99 patients converted to SR at 6 h. Backward elimination identified predictors as follows (AIC = 175.3): CHADS2 score, elective surgery, infection on ICU admission, serum potassium > 4.0 mmol/L, male sex, mechanical ventilation, and diagnostic grouping. The model showed good calibration for sustenance of AF at 6 h after the onset using the Hosmer-Lemeshow Chi-square value of 4.36 (degrees of freedom = 4, p = 0.360) indicating a good fit.CONCLUSIONS:These predictors might be useful in future interventional studies to identify patients who are likely to sustain new-onset AF.
DOI 10.1007/s00540-018-2537-1
PMID 30066166