title: Incidence and prognosis of sustained arrhythmias in critically ill patients.
abstract: BACKGROUND
  Sustained arrhythmias are common in postoperative and cardiac intensive care units (ICUs), but their incidence and prognosis in general ICUs have never been reported.
  
  
  OBJECTIVE
  To estimate the incidence and prognosis of sustained arrhythmias in a general ICU population.
  
  
  METHODS
  Prospective, multicenter, 1-month inception cohort study.
  
  
  RESULTS
  A total of 1,341 patients were included: 12% (163/1,341) had sustained arrhythmias, including 8% (113/1,341) and 2% (30/1,341) with supraventricular and ventricular arrhythmias, respectively, and 2% (30/1,341) with conduction abnormalities. In-hospital death rates were 17% (205/1,178) in patients without arrhythmia and 29% (33/113) in patients with supraventricular arrhythmias (odds ratio [OR], 1.95; 95% confidence interval [CI], 1.27-3.01), 73% (22/30) in patients with ventricular arrhythmias (OR, 13.20; 95% CI, 5.79-30.10), and 60% (18/30) in patients with conduction abnormalities (OR, 7.46; 95% CI, 3.52-15.82). Neurological sequel rates were 6% (55/973) in arrhythmia-free survivors and 15% (12/80) in survivors with supraventricular arrhythmias (OR, 2.92; 95% CI, 1.45-5.89), 38% (3/8) in survivors with ventricular arrhythmias (OR, 7.53; 95% CI, 1.60-35.50), and 17% (2/12) in survivors with conduction abnormalities (OR, 8.77; 95% CI, 1.65-46.57). After adjusting for prognosis factors and propensity scores, ventricular arrhythmias still increased mortality (OR, 3.53; 95% CI, 1.19-10.42) but supraventricular arrhythmias and conduction abnormalities did not.
  
  
  CONCLUSIONS
  Sustained arrhythmias are observed in 12% of patients admitted to general ICUs. Ventricular arrhythmias increase the risk of death.
authors.affiliation: Service de Réanimation Médicale, Hôpital Raymond Poincaré, 104 Boulevard Raymond Poincaré, 92380 Garches, France. djillali.annane@rpc.aphp.fr
authors.forename: Djillali
authors.initials: D
authors.lastname: Annane
authors.forename: Véronique
authors.initials: V
authors.lastname: Sébille
authors.forename: Denis
authors.initials: D
authors.lastname: Duboc
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Le Heuzey
authors.forename: Nicolas
authors.initials: N
authors.lastname: Sadoul
authors.forename: Erik
authors.initials: E
authors.lastname: Bouvier
authors.forename: Eric
authors.initials: E
authors.lastname: Bellissant
mesh_terms: D018806:APACHE; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000209:etiology*; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D016638:Critical Illness; D004562:Electrocardiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D011379:Prognosis; D012307:Risk Factors