Incident Stroke and Mortality Associated With New-Onset Atrial Fibrillation in Patients Hospitalized With Severe Sepsis

Study Questions:

What is the risk of stroke in new-onset atrial fibrillation (AF) associated with sepsis?

Methods:

This was a retrospective analysis of an inpatient database in which 49,082 patients (mean age 67 years) with severe sepsis were identified. The rates of stroke and death were compared between patients with and without new-onset AF.

Results:

New-onset AF occurred in 5.9% of patients with severe sepsis. The in-hospital stroke rate was 2.6% in patients with new-onset AF, 0.6% in patients with pre-existing AF, and 0.7% in patients with no AF. After adjusting for multiple confounding variables, new-onset AF was independently and significantly associated with a 2.7-fold increase in the risk of stroke and a 7% increase in the risk of in-hospital mortality.

Conclusions:

The authors concluded that new-onset AF in patients with severe sepsis increases the risk of in-hospital stroke and death.

Perspective:

It is possible that the risk of stroke was higher in patients with new-onset AF than in patients with pre-existing AF because patients with pre-existing AF were more likely to be adequately anticoagulated. Because the database used in this study did not allow identification of anticoagulation status, this explanation is conjectural.

Clinical Topics: Arrhythmias and Clinical EP, Atrial Fibrillation/Supraventricular Arrhythmias

Keywords: Stroke, Hospital Mortality, Atrial Fibrillation


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