Key result
In critically ill patients with pre-existing atrial fibrillation admitted to a stepdown unit, oral anticoagulant use was independently associated with an increased risk of death or ICU transfer (OR 1.61).
Why the study?
Limited data were available on the clinical course of patients with a history of AF admitted to an intensive care environment.
Does dicumarolic oral anticoagulant therapy impact the risk of therapeutic failure, stroke, and major bleeding in critically ill patients with atrial fibrillation admitted to a stepdown unit?
Population
1430 consecutive patients with AF history admitted to a SDU
Comparison
OAC use vs no OAC use
Design
Single-centre, observational retrospective analysis
Authors
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Urges caution with OAC in critically ill stepdown AF; leaves open optimal strategies and risk score utility in this population.
Observational (n=1,430)
No
Does dicumarolic oral anticoagulant therapy impact the risk of therapeutic failure, stroke, and major bleeding in critically ill patients with atrial fibrillation admitted to a stepdown unit?
Odds Ratio: 1.61 (95% CI 1.02–2.55)
In critically ill patients with AF in a stepdown unit, OAC use is associated with increased therapeutic failure, and standard risk scores fail to predict stroke or bleeding, highlighting the need for individualized management.
Falsetti et al. (2020) conducted an observational in Pre-existing atrial fibrillation in critically ill patients (n=1,430). Oral anticoagulant (OAC) therapy vs. No OAC use was evaluated on Therapeutic failure (composite of death or transfer to ICU) (OR 1.61, 95% CI 1.02-2.55). In critically ill patients with pre-existing atrial fibrillation admitted to a stepdown unit, oral anticoagulant use was independently associated with an increased risk of death or ICU transfer (OR 1.61).
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