Excess short-term mortality in noncritical patients with atrial fibrillation presenting to the emergency department

Wien Klin Wochenschr. 2021 Aug;133(15-16):802-805. doi: 10.1007/s00508-021-01895-y. Epub 2021 Jun 21.

Abstract

Background: Mortality data of non-critically ill patients presenting with symptomatic atrial fibrillation to an emergency department are scarce. We aimed to analyze the short-term mortality of these patients compared with that of the general Austrian population.

Design/methods: This study analyzed a consecutive series of non-critically ill adults presenting to the emergency department at the Medical University of Vienna between 2012 and 2016 with complaints related to atrial fibrillation. The study outcome was mortality during the observation period. Age-specific and sex-specific mortality rates per 100 person-years were calculated and compared with the mortality rates of the Austrian population during the same period.

Results: In total, 1754 patients with atrial fibrillation (43.1% female) were included in the study. During a median follow-up of 25 months, 248 of these patients died. Observed mortality rates were 7.8 per 100 person-years for females (95% confidence interval, CI 6.6-9.5) and 5.9 per 100 person-years for males (95% CI 5.0-7.1). Age-adjusted and sex-adjusted mortality rates were 2.8 (95% CI 2.3-3.3) and 2.7 (95% CI 2.2-3.2) per 100 person-years, respectively. Mortality rates for the Austrian population were 1.1 per 100 person-years for both females and males. Corresponding standardized mortality ratios were 2.5 for females (95% CI 2.1-3.0) and 2.4 for males (95% CI 2.0-2.9).

Conclusion: The short-term mortality of patients with symptomatic atrial fibrillation presenting to the emergency department was substantially higher compared with the general Austrian population.

Keywords: Arrhythmia; Atrial fibrillation; Emergency medicine; Mortality; Risk prediction.

MeSH terms

  • Adult
  • Aged, 80 and over
  • Atrial Fibrillation*
  • Austria
  • Emergency Service, Hospital
  • Female
  • Humans
  • Male