Atrial Fibrillation Is Not an Independent Determinant of Mortality Among Critically Ill Acute Ischemic Stroke Patients: A Propensity Score-Matched Analysis From the MIMIC-IV Database
Background/ObjectiveThis study was conducted to investigate the clinical characteristics and outcomes of patients with acute ischemic stroke and atrial fibrillation (AF) in intensive care units (ICUs).MethodsIn the Medical Information Mart for Intensive Care IV database, 1,662 patients with acute is...
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Frontiers Media S.A.
2022-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.730244/full |
| _version_ | 1819005126112706560 |
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| author | Chen-Shu Wu Po-Huang Chen Shu-Hao Chang Cho-Hao Lee Li-Yu Yang Li-Yu Yang Yen-Chung Chen Yen-Chung Chen Hong-Jie Jhou Hong-Jie Jhou |
| author_facet | Chen-Shu Wu Po-Huang Chen Shu-Hao Chang Cho-Hao Lee Li-Yu Yang Li-Yu Yang Yen-Chung Chen Yen-Chung Chen Hong-Jie Jhou Hong-Jie Jhou |
| author_sort | Chen-Shu Wu |
| collection | DOAJ |
| description | Background/ObjectiveThis study was conducted to investigate the clinical characteristics and outcomes of patients with acute ischemic stroke and atrial fibrillation (AF) in intensive care units (ICUs).MethodsIn the Medical Information Mart for Intensive Care IV database, 1,662 patients with acute ischemic stroke were identified from 2008 to 2019. Of the 1,662 patients, 653 had AF. The clinical characteristics and outcomes of patients with and without AF were compared using propensity score matching (PSM). Furthermore, univariate and multivariate Cox regression analyzes were performed.ResultsOf the 1,662 patients, 39.2% had AF. The prevalence of AF in these patients increased in a stepwise manner with advanced age. Patients with AF were older and had higher Charlson Comorbidity Index, CHA2DS2-VASc Score, HAS-BLED score, and Acute Physiology Score III than those without AF. After PSM, 1,152 patients remained, comprising 576 matched pairs in both groups. In multivariate analysis, AF was not associated with higher ICU mortality [hazard ratio (HR), 0.95; 95% confidence interval (CI), 0.64–1.42] or in-hospital mortality (HR, 1.08; 95% CI, 0.79–1.47). In Kaplan–Meier analysis, no difference in ICU or in-hospital mortality was observed between patients with and without AF.ConclusionsAF could be associated with poor clinical characteristics and outcomes; however, it does not remain an independent short-term predictor of ICU and in-hospital mortality among patients with acute ischemic stroke after PSM with multivariate analysis. |
| first_indexed | 2024-12-20T23:47:50Z |
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| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-20T23:47:50Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-d359f15e8d1742b68fa7cb112c5aac2e2022-12-21T19:22:55ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-01-011210.3389/fneur.2021.730244730244Atrial Fibrillation Is Not an Independent Determinant of Mortality Among Critically Ill Acute Ischemic Stroke Patients: A Propensity Score-Matched Analysis From the MIMIC-IV DatabaseChen-Shu Wu0Po-Huang Chen1Shu-Hao Chang2Cho-Hao Lee3Li-Yu Yang4Li-Yu Yang5Yen-Chung Chen6Yen-Chung Chen7Hong-Jie Jhou8Hong-Jie Jhou9Department of Internal Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, TaiwanDepartment of Internal Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, TaiwanDepartment of Computer Science and Information Science, National Formosa University, Yunlin, TaiwanDivision of Hematology and Oncology Medicine, Department of Internal Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, TaiwanSchool of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Neurology, Changhua Christian Hospital, Changhua, TaiwanDepartment of Neurology, Changhua Christian Hospital, Changhua, TaiwanDepartment of Public Health, Chung Shan Medical University, Taichung, TaiwanSchool of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Neurology, Changhua Christian Hospital, Changhua, TaiwanBackground/ObjectiveThis study was conducted to investigate the clinical characteristics and outcomes of patients with acute ischemic stroke and atrial fibrillation (AF) in intensive care units (ICUs).MethodsIn the Medical Information Mart for Intensive Care IV database, 1,662 patients with acute ischemic stroke were identified from 2008 to 2019. Of the 1,662 patients, 653 had AF. The clinical characteristics and outcomes of patients with and without AF were compared using propensity score matching (PSM). Furthermore, univariate and multivariate Cox regression analyzes were performed.ResultsOf the 1,662 patients, 39.2% had AF. The prevalence of AF in these patients increased in a stepwise manner with advanced age. Patients with AF were older and had higher Charlson Comorbidity Index, CHA2DS2-VASc Score, HAS-BLED score, and Acute Physiology Score III than those without AF. After PSM, 1,152 patients remained, comprising 576 matched pairs in both groups. In multivariate analysis, AF was not associated with higher ICU mortality [hazard ratio (HR), 0.95; 95% confidence interval (CI), 0.64–1.42] or in-hospital mortality (HR, 1.08; 95% CI, 0.79–1.47). In Kaplan–Meier analysis, no difference in ICU or in-hospital mortality was observed between patients with and without AF.ConclusionsAF could be associated with poor clinical characteristics and outcomes; however, it does not remain an independent short-term predictor of ICU and in-hospital mortality among patients with acute ischemic stroke after PSM with multivariate analysis.https://www.frontiersin.org/articles/10.3389/fneur.2021.730244/fullischemic stroke (IS)atrial fibrillationintensive care unit (ICU)MIMIC-IVpropensity score matching (PSM) |
| spellingShingle | Chen-Shu Wu Po-Huang Chen Shu-Hao Chang Cho-Hao Lee Li-Yu Yang Li-Yu Yang Yen-Chung Chen Yen-Chung Chen Hong-Jie Jhou Hong-Jie Jhou Atrial Fibrillation Is Not an Independent Determinant of Mortality Among Critically Ill Acute Ischemic Stroke Patients: A Propensity Score-Matched Analysis From the MIMIC-IV Database Frontiers in Neurology ischemic stroke (IS) atrial fibrillation intensive care unit (ICU) MIMIC-IV propensity score matching (PSM) |
| title | Atrial Fibrillation Is Not an Independent Determinant of Mortality Among Critically Ill Acute Ischemic Stroke Patients: A Propensity Score-Matched Analysis From the MIMIC-IV Database |
| title_full | Atrial Fibrillation Is Not an Independent Determinant of Mortality Among Critically Ill Acute Ischemic Stroke Patients: A Propensity Score-Matched Analysis From the MIMIC-IV Database |
| title_fullStr | Atrial Fibrillation Is Not an Independent Determinant of Mortality Among Critically Ill Acute Ischemic Stroke Patients: A Propensity Score-Matched Analysis From the MIMIC-IV Database |
| title_full_unstemmed | Atrial Fibrillation Is Not an Independent Determinant of Mortality Among Critically Ill Acute Ischemic Stroke Patients: A Propensity Score-Matched Analysis From the MIMIC-IV Database |
| title_short | Atrial Fibrillation Is Not an Independent Determinant of Mortality Among Critically Ill Acute Ischemic Stroke Patients: A Propensity Score-Matched Analysis From the MIMIC-IV Database |
| title_sort | atrial fibrillation is not an independent determinant of mortality among critically ill acute ischemic stroke patients a propensity score matched analysis from the mimic iv database |
| topic | ischemic stroke (IS) atrial fibrillation intensive care unit (ICU) MIMIC-IV propensity score matching (PSM) |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2021.730244/full |
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