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Outcomes of new-onset atrial fibrillation in patients with sepsis: A systematic review and meta-analysis of 225,841 patients

Published:January 04, 2021DOI:https://doi.org/10.1016/j.ajem.2020.12.062

      Highlights

      • The incidence of atrial fibrillation (AF) in sepsis varied with different conditions.
      • Patients with sepsis-related new-onset AF had prolonged ICU and hospital stays.
      • New-onset AF was correlated with increased mortality, stroke risk and recurrence of AF.

      Abstract

      Background

      The outcomes of new-onset atrial fibrillation (AF) during sepsis are inconsistent and inconclusive. This meta-analysis aims to provide a comprehensive description of the impact of new-onset AF on the prognosis of sepsis.

      Methods

      Three electronic databases (PubMed, Embase, and the Cochrane Library) were searched for relevant studies. Meta-analysis was performed using odds ratios (OR) and 95% confidence intervals (CI) as effect measures.

      Results

      A total of 225,841 patients from 13 individual studies were incorporated to the meta-analysis. The summary results revealed that new-onset AF during sepsis was associated with increased odds of in-hospital mortality (pooled OR: 2.09; 95% CI: 1.53–2.86; p < 001), post-discharge mortality (pooled OR: 2.44; 95% CI: 1.81–3.29; p < .001), and stroke (pooled OR:1.88; 95% CI: 1.13–3.14; p < .05). Results also indicated that the incidence of new-onset AF varied from 1.9% for mild sepsis to 46.0% for septic shock. Furthermore, compared to those without AF, people with new-onset AF had longer ICU and hospital stays, as well as a higher recurrence of AF.

      Conclusions

      New-onset AF is frequently associated with adverse outcomes in patients with sepsis. This is a clinical issue that warrants more attention and should be managed appropriately to prevent poor prognosis.

      Keywords

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