Abstract 15322: Risk of Atrial Fibrillation in Critically Ill Septic Patients Varies According to the Microbiological Etiology

• Published in: Circulation (New York, N.Y.) N.Y.), 2018-11, Vol.138 (Suppl_1 Suppl 1), p.A15322-A15322
• Main Authors: Acharya, Prakash, Poudel, Dilli R, Bharati, Rajani, Acharya, Sabita, Gitler, Bernard, Jesmajian, Stephen
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539

IntroductionAtrial fibrillation is a common arrhythmia in critically ill septic patients which is associated with higher short-term and long-term complications. We aim to determine whether the risk of atrial fibrillation in critically ill septic patients differ according to the category of organism causing the infection.MethodsThis is a single center, retrospective, cohort study done utilizing the Medical Information Mart for Intensive Care (MIMIC-III) database. All critically ill septic patients over 16 years of age admitted to the medical intensive care unit between 2001 and 2012 were included. Septic patients were identified when they meet the clinical criteria from the third consensus definition of sepsis and septic shock. Data on incidence of atrial fibrillation and culture report were collected. Microorganism considered contaminants and colonizers were excluded. The risk of atrial fibrillation was estimated by cox proportional hazard regression after adjusting for patient variables and covariates including severity of sepsis.ResultsAmong 61,532 patients admitted to the intensive care unit, 7,322 patients met both the inclusion criteria and the Sepsis -3 criteria. Among them, we analyzed 1653 patients who had at least one positive culture. The incidence of atrial fibrillation was 24.17% and the median time to atrial fibrillation was 33.35 hours. The risk of atrial fibrillation was highest with fungal infection (HR 1.66, [1.12-2.46] p value 0.01). Gram negative infection had lower risk of atrial fibrillation compared to gram positive infection (HR 0.72, [0.56-0.93] p-value 0.01).ConclusionsThe risk of atrial fibrillation in critically ill septic patients can vary according to the category of organism causing the infection. The exact reason and mechanism for this difference is unclear and will require further investigation in a controlled setting.