Key result
Acute AF onset during acute ischemic stroke is linked to ~74% higher 30-day mortality.
Why the study?
It was unknown whether acute atrial fibrillation in the emergency department affects the outcomes of acute ischemic stroke patients.
Does acute atrial fibrillation onset in the emergency department increase the severity of early neurological deficits and 30-day mortality in patients with acute ischemic stroke?
Cohort (n=706)
No
Does acute atrial fibrillation onset in the emergency department increase the severity of early neurological deficits and 30-day mortality in patients with acute ischemic stroke?
Effect estimate: OR 1.74 (95% CI 1.01-2.98)
Absolute Event Rate: 30.3% vs 10.1%
p-value: p=0.044
Acute atrial fibrillation detected in the emergency department during acute ischemic stroke is an independent predictor of early neurological deficit severity and 30-day mortality.
Acute AF onset may flag higher 30-day mortality risk in acute ischemic stroke; hypothesis-generating and should not yet change practice.
Patients with atrial fibrillation (AF) have a higher risk of ischemic stroke. However, it is still unknown whether acute atrial fibrillation (AAF) in the emergency department can affect the outcomes of acute ischemic stroke (AIS) patients. In this study, the risk and prognosis of AIS patients with AFF were assessed with a total of 706 identified patients, who were grouped based on their AF history. Logistic regression showed that age ≥ 73 (OR: 2.00; 95% CI: 1.18–3.37; p = 0.010), baseline NIHSS score (OR: 1.18; 95% CI: 1.15–1.22; p < 0.001), and AAF onset (OR: 1.87; 95% CI: 1.09–3.19; p = 0.022), were independent risk factors of severity of early neurological deficits in AIS. Baseline NIH Stroke Scale/Score (NIHSS) (OR: 1.11; 95% CI: 1.08 to 1.13; p < 0.001) and AAF onset (OR: 1.74; 95% CI: 1.01 to 2.98; p = 0.044) were independent predictors of the mortality. AAF in the emergency department was not only an independent risk factor for the severity of early AIS neurological deficits, but also an indicator of high probability of post-stroke death in 30 days.
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Li et al. (2022) conducted a cohort in Acute Ischemic Stroke (n=706). Acute Atrial Fibrillation (AAF) onset vs. No Acute Atrial Fibrillation was evaluated on 30-day mortality (OR 1.74, 95% CI 1.01-2.98, p=0.044). Acute atrial fibrillation onset in patients with acute ischemic stroke was an independent predictor of 30-day mortality (OR 1.74) compared to patients without acute atrial fibrillation.
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