Details

Autor(en) / Beteiligte

• An, Selena J.
• Davis, Dylane
• Peiffer, Sarah
• Gallaher, Jared
• Tignanelli, Christopher J.
• Charles, Anthony

Titel

Arrhythmias in Critically Ill Surgical and Non-surgical Patients: A National Propensity-Matched Study

Ist Teil von

• World journal of surgery, 2023-11, Vol.47 (11), p.2668-2675

Ort / Verlag

Cham: Springer International Publishing

Erscheinungsjahr

2023

Quelle

SpringerLink Journals

Beschreibungen/Notizen

• Background Arrhythmias are common in critically ill patients, though the impact of arrhythmias on surgical patients is not well delineated. We aimed to characterize mortality following arrhythmias in critically ill patients. Methods We performed a propensity-matched retrospective analysis of intensive care unit (ICU) patients from 2007 to 2017 in the Cerner Acute Physiology and Chronic Health Evaluation database. We compared outcomes between patients with and without arrhythmias and those with and without surgical indications for ICU admission. We also modeled predictors of arrhythmias in surgical patients. Results 467,951 patients were included; 97,958 (20.9%) were surgical patients. Arrhythmias occurred in 1.4% of the study cohorts. Predictors of arrhythmias in surgical patients included a history of cardiovascular disease (odds ratio [OR] 1.35, 95% confidence interval [CI95] 1.11–1.63), respiratory failure (OR 1.48, CI95 1.12–1.96), pneumonia (OR 3.17, CI95 1.98–5.10), higher bicarbonate level (OR 1.03, CI95 1.01–1.05), lower albumin level (OR 0.79, CI95 0.68–0.91), and vasopressor requirement (OR 27.2, CI95 22.0–33.7). After propensity matching, surgical patients with arrhythmias had a 42% mortality risk reduction compared to non-surgical patients (risk ratio [RR] 0.58, CI 95 0.43–0.79). Predicted probabilities of mortality for surgical patients were lower at all ages. Conclusions Surgical patients with arrhythmias are at lower risk of mortality than non-surgical patients. In this propensity-matched analysis, predictors of arrhythmias in critically ill surgical patients included a history of cardiovascular disease, respiratory complications, increased bicarbonate levels, decreased albumin levels, and vasopressor requirement. These findings highlight the differential effect of arrhythmias on different cohorts of critically ill populations.