title: Epidemiology and patient outcome after medical emergency team calls triggered by atrial fibrillation.
abstract: BACKGROUND
  Atrial fibrillation (AF) in hospitalized patients may lead to activation of the medical emergency team (MET). We sought to assess the baseline characteristics and outcomes of the patients presenting AF as a cause of MET call activation.
  
  
  METHODS
  Using a prospectively constructed MET database, we retrospectively reviewed all patients with AF as a trigger for MET activation between August 2005 and April 2010. Demographics, principal diagnostic and outcome of these patients were compared with those of a control group of patients matched for age, sex and ward of origin, randomly selected from the database.
  
  
  RESULTS
  We studied 5431 MET calls of which 557 (10.3%), in 458 patients were triggered by AF. Mean age for AF patients was 74.8 years, 230 (50.2%) were female and 271 (59.1%) were in a surgical ward. 92 (20.1%) AF patients died in hospital compared with 131 (28.6%) in the control group. Among the 336 patients without limitations of medical therapy (LOMT), 46 (13.7%) died in hospital. In total, 46 (13.7%) patients were transferred to a higher level care ward while 290 (86.3%) remained on the ward. Only 2 (4.3%) of these patients died compared with 44 (15.2%) among those who remained in the general ward (p=0.03).
  
  
  CONCLUSIONS
  In our hospital, AF triggers one tenth of MET activations and mortality associated with it is high even when issues of LOMT are excluded. The decreased mortality among patients admitted to a higher level ward suggests that some of these deaths may be avoidable.
authors.affiliation: Intensive Care Unit, Austin Health, 145 Studley Road, 3084 Heidelberg, Melbourne, Victoria, Australia.
authors.forename: Antoine
authors.initials: A
authors.lastname: Schneider
authors.forename: Paolo
authors.initials: P
authors.lastname: Calzavacca
authors.forename: Daryl
authors.initials: D
authors.lastname: Jones
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000628:therapy*; D004630:Emergencies; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010348:Patient Care Team; D012189:Retrospective Studies; D016896:Treatment Outcome; D014218:Triage / Q000458:organization & administration*; D014739:Victoria