CHA₂DS₂-VASc score and in-hospital mortality in critically ill patients with new-onset atrial fibrillation

Abstract Objective To examine the role of the CHA₂DS₂-VASc score as a prognostic marker of in-hospital mortality in critically ill patients who develop new-onset atrial fibrillation (NOAF). Design Retrospective analyses Setting A single-center study in a tertiary care academic medical center Participants The study comprised of all adult patients with NOAF admitted to non-cardiac intensive care units (ICUs) at a tertiary care academic institution between January 2009 and March 2016. Interventions None Measurements and main results We retrospectively reviewed electronic medical records of all adult patients admitted to non-cardiac intensive care units (ICUs) at a tertiary care academic institution between January 2009 and March 2016. Patients with NOAF were identified and their CHA₂DS₂-VASc score was calculated. We evaluated the association of CHA₂DS₂-VASc score and its individual components with in-hospital mortality in these patients. A total of 640 (1.7% [38708 patients]; 95% CI 1.5%,1.8%) patients developed NOAF during the study period. The in-hospital mortality rate in patients included in the analysis was 14.3%. There was no association between in-hospital mortality and CHA₂DS₂-VASc score. However, the likelihood of in-hospital death was 1.56 times greater for patients having atrial fibrillation and concomitant vascular disease (95%CI 1.003, 2.429; p=0.049). Conclusion NOAF is common in critically ill patients and is associated with high in-hospital mortality. We found that the CHA₂DS₂-VASc score itself is not a reliable prognostic marker of in-hospital mortality in these patients. However, the presence of vascular disease in patients with NOAF may increase the mortality associated with this disease.