New-onset atrial fibrillation in patients with severe sepsis ups in-hospital stroke, death risk
TUESDAY, Nov. 15 (HealthDay News) -- Patients who develop new-onset atrial fibrillation (AF) during hospitalization for severe sepsis are at an increased risk of in-hospital stroke and mortality, according to a study published online Nov. 13 in the Journal of the American Medical Association to coincide with presentation at the American Heart Association's Scientific Sessions 2011, held from Nov. 12 to 16 in Orlando, Fla.
Allan J. Walkey, M.D., from Boston University School of Medicine, and colleagues estimated the in-hospital stroke and mortality risk associated with new-onset AF in 49,082 patients (mean age, 69 years; 48 percent women) with severe sepsis. Administrative claims data were collected from the California State Inpatient Database from nonfederal acute care hospitals in 2007. AF was considered new-onset if it occurred during the hospital stay. In-hospital ischemic stroke was the main outcome measure.
The investigators found that 5.9 and 0.65 percent of patients with and without severe sepsis developed new-onset-AF, respectively (multivariable-adjusted odds ratio [OR], 6.82). Of all new-onset AF cases in hospitalized adults, 14 percent had severe sepsis. Patients who developed new-onset AF during severe sepsis had a significantly higher risk of in-hospital stroke (adjusted OR, 2.70) and mortality (adjusted relative risk, 1.07) than patients with severe sepsis without new-onset AF. These findings persisted using multiple sensitivity analyses, across two definitions of severe sepsis, and with multiple methods of addressing confounding.
"Among patients with severe sepsis, patients with new-onset AF were at increased risk of in-hospital stroke and death compared with patients with no AF and patients with preexisting AF," the authors write.