| Objective: 1.To investigate the epidemiological characteristics of new-onset arrhythmia in critically ill patients,and to explore the prognostic factors of severe patients with new arrhythmia.2.To explore the correlation between the routine detection index and the new-onset AF and to find out risk factors for new-onset AF in critically ill patients.Methods: Prospective observational studies were used.1.Clinical observation of severe patients who were admitted to the intensive care unit(ICU)in the affiliated hospital of Gui zhou medical university from march 2016 to October 2017.Collecting eligible patients,and describe its overall characteristics.The patients were divided into the death group and the survival group by 28 d,the differences in clinical data were compared between the two groups,Logistic regression was used to analyze the risk factors for 28 days of death.2.The patients who were admitted to the ICU in the ICU from March 2016 to June 2017 were selected.The patients were divided into new-onset AF group and past-existed AF group according to their past history of AF(including persistent AF,paroxysmal AF or permanent AF).In addition,patients in ICU without history of AF and new-onset AF were selected as the control group(no AF group).General epidemiological characteristics of 3 groups of patients were analyzed.Pearson or Spearman rank correlation was used for analysis correlation between indexes and new atrial fibrillation.Risk factors of new-onset AF were analyzed by Logistic regression analysis.Results: 1.A total of 2238 patients were admitted during the study,among them,358 patients with new arrhythmia(incidence 16.00%),and there were 196 cases of supraventricular arrhythmia(incidence 8.76%),66 cases of ventricular arrhythmia(2.95%),24 cases of conduction block(1.07%),and 72 cases of sinus bradycardia(3.22%);Male 221 cases and 137 females;age(64.90 + 16.65);the 28-day survival rate was 55.18% and 41.31% in 90 days.Binary classification Logistic regressionanalysis showed that ICU length of hospital stay(odds ratio(OR)= 0.998,P = 0.001),APACHE II score(OR = 1.067,P = 1.067),the SOFA score(OR = 1.170,P = 1.170)are risk factors for 28 days of death for new-onset arrhythmia patients.2.There were 179 cases of atrial fibrillation and 75 cases of new-onset atrial fibrillation.The incidence of new atrial fibrillation was 4.48%(75/1673),and have a 28-day mortality of 45.33%(34/75).Correlation analysis showed that Age,APACHEⅡscore,septic shock,HF,cardiovascular disease,renal insufficiency were positively correlated with new-onset AF(r value were 0.393,0.270,0.386,0.251,0.194,0.170;P value were0.000,0.001,0.000,0.002,0.017,0.037,respectively).the age(OR = 0.962,P =0.046),initial oxygenation index(OR = 1.005,P = 0.028)and plasma potassium levels(OR = 1.638,P = 0.022)were the risk factors for new-onset AF.Conclusion:1.The proportion of new-onset arrhythmia in patients with critical disease is higher,and the patients with arrhythmias are mainly in the supraventricular arrhythmia,and All kinds of arrhythmias have a poor prognosis.2.ICU length of hospital stay shorter,APACHE II score higher,the SOFA score higher are risk factors for 28 days of death for new-onset arrhythmia patients.3.new-onset AF significantly prolong the length of ICU stay;APACHE Ⅱ score,septic shock,cardiovascular disease,and renal insufficiency are related to new-onset AF;age,basic oxygenation index and plasma potassium level are risk factors for new-onset AF. |
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