Afib Onset in Sepsis May Be Prognostic for Stroke

This report is part of a 12-month Clinical Context series.
By Crystal Phend, Senior Staff Writer, MedPage Today
Published: November 13, 2011
Reviewed by Michael Mullen, MD; Clinical Instructor of Vascular Neurology, University of Pennsylvania and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

ORLANDO — Atrial fibrillation that develops during severe sepsis predicts high mortality and stroke risk, an observational study found.

Fully 56% of severe sepsis patients with new-onset atrial fibrillation died in the hospital compared with 39% mortality among other severe sepsis patient, reported Allan J. Walkey, MD, MSc, of Boston University, at the American Heart Association meeting.

After adjustment for other factors, the excess risk from developing the arrhythmia during hospitalization for severe sepsis was only 7%, but remained significant atP<0.001 in the population-based study, released simultaneously online in the Journal of the American Medical Association.

Incident atrial fibrillation also more than doubled the risk of having a stroke during hospitalization for severe sepsis, with a rate of 2.6% compared with 0.6% among other severe sepsis patients (adjusted odds ratio 2.70,P<0.001).

If causal links are found, these results could be important for intensivists, noted Christopher H. Goss, MD, MSc, of the University of Washington in Seattle, and Shannon S. Carson, MD, of the University of North Carolina at Chapel Hill, in a JAMA editorial accompanying the paper. Read Full Article