New-onset atrial fibrillation-related ischemic stroke occurring after hospital discharge in septicemia survivors

作者：Cheng C A; Cheng C G; Lin H C; Lee J T; Lin H C; Cheng C C; Chien W C; Chiu H W

来源：QJM-An International Journal of Medicine, 2017, 110(7): 447-452.

DOI：10.1093/qjmed/hcx025

Background: Sepsis will induce stroke, new-onset atrial fibrillation (AF) increase ischemic stroke (IS) in in-hospitalization and long-term period after sepsis. Physicians must alert this condition and given suitable treatment.
Aim: The associated of IS and new-onset AF in septicemia survivors after discharge have to be evaluated.
Design: The inpatient data was used of the Taiwan National Health Insurance Database (NHIRD) in 2010. We identified patients suffered their first occurrence of septicemia (International Classification of Disease, Ninth Revision, Clinical Modification [ICD-9-CM] is 038, 003.1, 036.1) and excluded less than 18 years old. Patients had AF (ICD-9-CM to 427.3 x) during the same admission or after septicemia hospitalization discharged were defined as new-onset AF. The outcome was IS happened after septicemia discharge (ICD-9-CM as 433-437).
Methods: The factors related to IS after septicemia survival were established using multivariate logistic regression with forward stepwise selection.
Results: There were 1286 new-onset AF and 1026 IS happened after septicemia discharge. The crude odds ratio (OR) were 3.88 (95% confidence interval [C.I.]: 1.69-8.89) and 1.62 (95% C.I.: 1.14-2.3) in middle-aged and elderly septicemia survivors with new-onset AF induced IS. The risk of IS after septicemia survivors was noticed adjusted OR 1.74 (95% C.I.: 1.26-2.41) for new-onset AF.
Conclusion: The middle-aged and elderly septicemia survivors suffered from new-onset AF had increased incidence of IS within three months. New-onset AF was a mediator factor of IS in septicemia survivors of Asian population.

• 出版日期2017-7