P1286Atrial fibrillation and infection among acute patients in the Emergency Department: a multicentre cohort study of prevalence and prognosis

Introduction: Patients with infection presenting with atrial fibrillation (AF) are frequent in emergency departments (ED). This combination is probably related to a poor prognosis compared to AF or infection, but existing data are scarce. Purpose: To describe the prevalence and prognosis for AF and infection, individually and concomitantly in an ED setting. Methods: Cohort study in adult (≥18 years) ED patients with ECG performed on presentation at 2 hospitals in Denmark, from March 13 2013 to April 30 2014. AF was identified by electronic ECG records, manually validated with a kappa value of 0.86 (95% CI, 0.782 to 0.947) and a predictive positive value of 95%, (95% CI, 81.8 to 99.3), and infection was identified based on discharge diagnoses. The absolute 30-day mortality and stroke rate were calculated for all patients, for those with AF, infection and those with both. Results: Among 39393 contacts to the ED, 27879 patients (median age 66, 50% women) had an ECG recorded and were included in the study. 2341 (8.4%) had AF, 5672 (20.3%) had an infection and 670 (2.4%) had both infection and AF, of which 230 (34.3%) had no previous AF diagnosis or AF identified by ECG (new-onset AF).