Atrial fibrillation increased in-hospital and 4-year all-cause mortality in Critically ill patients with liver cirrhosis

Abstract ObjectiveThe purpose of this study was to use a large database that contains information on patient intensive care unit (ICU) admissions to study critically ill patients with cirrhosis and the relation with atrial fibrillation and short-term and 4-year mortality. MethodsThe Monitoring in Intensive Care Database III database was used to identify patients with cirrhosis hospitalized in an ICU from 2001 to 2012. Demographic and clinical data were extracted from the database. Clinical data and demographic information were collected for each patient in our study. Kaplan-Meier analysis and multivariate Cox regression models were performed to examine the relation between atrial fibrillation and in-hospital and 4-year all-cause mortality. ResultsA total of 1,481 patients (mean age 58 years, 68% male) with liver cirrhosis treated in an ICU were included in the analysis, and the prevalence of atrial fibrillation was 14.2%. The in-hospital all-cause mortality rate was 26.60%, and patients who had a significantly higher rate of atrial fibrillation (21.57% vs. 11.50%, P < 0.001). Multivariate analysis indicated that atrial fibrillation was significantly associated with in-hospital all-cause mortality (hazard ratio [HR] = 1.52, 95% confidence interval [CI]: 1.19 to 1.95; P < 0.001), and 4-year all-cause mortality (HR = 1.55, 95% CI: 1.12 to 2.13; P = 0.008). Kaplan-Meier survival analysis showed that patients with atrial fibrillation had a significantly higher in-hospital and 4-year all-cause mortality rate than patients without atrial fibrillation. ConclusionsCritically ill patients with liver cirrhosis have a significantly increased rate of atrial fibrillation, and the presence of atrial fibrillation is an independent risk for in-hospital and 4-year all-cause mortality.