3 Age and sex-dependent risks in ICU admission and mortality among atrial fibrillation patients with active infections

<h3>Background</h3> Atrial fibrillation (AF) is the most common arrhythmia in the ICU and general population associated with cardiomyopathy, stroke, and premature mortality. <h3>Aim</h3> Investigate the relationship between atrial fibrillation (AF), age, and infection status in predicting ICU admission/mortality. <h3>Methods</h3> Data from the ‘Impact of Atrial Fibrillation in Critically Ill Patients Admitted to a Stepdown Unit’ was used. Our primary objective was to investigate the relationship between AF, age, and infection status in predicting ICU admission/mortality. AF types (AFT) were categorized into two groups: Paroxysmal AF, Persistent &amp; Permanent AF. Age was dichotomized: &lt;60 years, ≥60 years. Outcome was ICU admission/death, or discharge/transfer to low-intensity department. A logistic regression analysis was done to evaluate the combined effect of AFT and age. An interaction variable was created by cross-tabulating AFT and age groups. Then, we performed subgroup analyses based on sex to explore its impact on the measured association. The influence of infection status was assessed by removing it from the model. Despite this removal, the significance of sex male persisted, suggesting an association with the outcome. <h3>Results</h3> As per table 1, the interaction variable (p &lt; 0.001) indicated that the impact of AF on the outcome may vary depending on patient’s age. We observed a significant association of sex with the outcome, male patients showed a significantly higher risk (p = 0.005) for ICU admission/death, while female patients showed no effect. Hypertension had a significant protective effect (p &lt; 0.001) and the presence of stroke was identified as a risk factor (p = 0.035). <h3>Conclusion</h3> Our findings highlight that patients aged 60+ with Paroxysmal-AF are at a higher risk for ICU admission/death, particularly among males with a history of stroke. The sex-based difference highlights the need to take into consideration both age and sex as critical factors when managing AF patients.