New-onset atrial fibrillation in sepsis is associated with increased morbidity and mortalityReportar como inadecuado




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Netherlands Heart Journal

, Volume 23, Issue 2, pp 82–88

First Online: 09 January 2015DOI: 10.1007-s12471-014-0641-x

Cite this article as: Gandhi, S., Litt, D. & Narula, N. Neth Heart J 2015 23: 82. doi:10.1007-s12471-014-0641-x

Abstract

BackgroundThe development of new-onset atrial fibrillation in sepsis has been associated with adverse outcomes.

MethodsA 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.

ResultsSix 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, I24 %. 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.

ConclusionProspective 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.

KeywordsAtrial fibrillation Arrhythmia Sepsis Intensive care unit Mortality  Download fulltext PDF



Autor: Sumeet Gandhi - Dhanjit Litt - Neeraj Narula

Fuente: https://link.springer.com/







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