New-onset atrial fibrillation in sepsis is associated with increased morbidity and mortality

作者：Gandhi Sumeet^*; Litt Dhanjit; Narula Neeraj

来源：Netherlands Heart Journal, 2015, 23(2): 82-88.

DOI：10.1007/s12471-014-0641-x

• Atrial fibrillation
• Arrhythmia
• Sepsis
• Intensive care unit
• Mortality

Background The development of new-onset atrial fibrillation in sepsis has been associated with adverse outcomes.
Methods A systematic literature search was conducted to retrieve articles that investigated the association of new-onset atrial fibrillation in patients diagnosed with sepsis. The primary outcome of interest was the pooled risk ratio (RR) of in-hospital mortality in patients with new-onset atrial fibrillation and sepsis.
Results Six studies included 3100 patients with new-onset atrial fibrillation in sepsis and 36,900 patients without new-onset atrial fibrillation in sepsis. The pooled RR for in-hospital mortality was 1.45 (95 % CI 1.32-1.60, p < 0.00001, I(2=)24 %). New-onset atrial fibrillation was also associated with increased ICU mortality, ICU and in-hospital length of stay and stroke. New-onset atrial fibrillation occurred more in the elderly, those with a prior history of cardiovascular and respiratory disease, and those with increased severity of illness.
Conclusion Prospective randomised trials are needed to clarify the significance of new-onset atrial fibrillation in sepsis, optimal treatment strategies for these patients, and the benefit of systemic anticoagulation. Physicians should be aware that new-onset atrial fibrillation in sepsis is not merely an observed temporary arrhythmia but a marker of poor prognosis and should be managed accordingly.

• 出版日期2015-2