Chen et al identified factors associated with 60-day mortality following admission to a medical intensive care unit (ICU). The study emphasized the importance of new-onset atrial fibrillation on outcomes. The authors are from the University of Chicago.


Patient selection: age >= 18 years, admitted to a medical ICU for > 24 hours

Exclusion: arrhythmia prior to ICU admission, surgical patient, history of ICU admission in past 90 days, transfer from an ICU outside of institution


Outcome: 60-day mortality after ICU admission (page 525)


Predictors from multivariate analysis:

(1) APACHE II score based on worst variables during first 24 hours after admission

(adjusted odds ratio 1.06 per point, maximum 71 points))

(2) new-onset atrial fibrillation (adjusted OR 1.99)

(3) septic shock (adjusted OR 2.78)

(4) continuous renal replacement therapy (adjusted odds rati 2.93)


cumulative product of adjusted odds ratio for mortality =

= PRODUCT(adjusted odds ratios for predictors)



• minimum cumulative product: 1

• maximum cumulative product:1,015

• The higher the cumulative product of AOR the greater the 60-day mortality.


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