Clinical characteristics and mortality of patients in the intensive care unit with and without new-onset arrhythmias

Objective. The aims of this study were to analyze the risk factors for and types of new-onset arrhythmias in ICU (Intensive care unit), and to evaluate their impact on patient outcomes.

Methods. We studied 1051 patients who were admitted to the two general ICUs between December 2013 and February 2016. These patients were divided into two groups: patients with new-onset arrhyth-mias and patients without new-onset ar-rhythmias. We compared the risk factors, types and prognoses of new-onset arrhyth-mias between these two groups.

Results. New-onset arrhythmias were ob-served in 20.84% (n=219) of 1051 patients. The main risk factors leading to arrhythmi-as included age, emergency operation, past cardiovascular disease, patients with multi-ple systemic diseases, acute respiratory dis-tress syndrome, severe sepsis/septic shock, acute renal dysfunction, cardiovascular disease, electrolyte disturbance, patients on ventilators, patients on vasopressors and higher Acute Physiology and Chronic Health Evaluation II scores (APACHE II score) on ICU admission. Multivari-ate logistic regression revealed that age, emergency operation, severe sepsis/septic shock, cardiovascular disease, electrolyte disturbance, patients on ventilators and those with higher APACHE II scores on ICU admission, were all significantly asso-ciated with new-onset arrhythmias. Arial fibrillation was the most frequent arrhyth-mia. ICU mortality in patients with new-onset arrhythmias was 22.37% (49 out of 219) compared with 3.61% (30 out of 832) in patients without new-onset arrhythmias (p<0.001). Among surviving patients, ICU stay for those with new-onset arrhythmias was longer than those without new-onset arrhythmias (median stay of 10 days versus 5 days, p<0.001).

Conclusion. We found a high prevalence of new-onset arrhythmias in ICU patients. Arrhythmia, especially atrial fibrillation, was a common complication in ICU pa-tients and was associated with increasing length of ICU stay and higher mortality. 

arrhythmia, intensive care unit, critical illness, mortality

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