Introduction
Mechanism of new-onset atrial fibrillation in sepsis
Methods
Study selection
Inclusion criteria
Outcomes of interest
Study quality and data extraction
Results
Search results
Author (year) | Study design | Inclusion | Exclusion | Quality of studya
|
---|---|---|---|---|
Walkey et al. [25] | Retrospective | California State Independent database claims, adults hospitalised with severe sepsis |
n/a
| 6 |
Wells et al. [26] | Retrospective | Admitted to the medical ICU with sepsis | Recent myocardial injury, malignancy | 6 |
Kumar et al. [22] | Retrospective | Nationwide Inpatient Sample 2007 database, adults diagnosed with severe sepsis or septic shock |
n/a
| 5 |
Meierhenrich et al. [23] | Prospective | Admitted to general surgical ICU, diagnosed with septic shock | If underwent cardiac surgery, previous history of known AF | 9 |
Goodman et al. [12] | Prospective | Admitted to general surgical ICU, diagnosed with sepsis | Recent thoracic surgery, sustained thoracic trauma | 7 |
Salman et al. [19] | Retrospective | Admitted to a medical-surgical ICU diagnosed with sepsis, severe sepsis, septic shock | Previous AF | 8 |
Christian et al. [20] | Retrospective | Admitted to a medical-surgical ICU diagnosed with sepsis | If underwent cardiothoracic injury, acute MI, acute pulmonary embolism | 9 |
Seguin et al. [24] | Prospective | Admitted to a surgical ICU | AF on admission, permanent pacemaker | 6 |
Author (year) | Mean age (years), female | Comorbidities | ||
---|---|---|---|---|
New-onset AF | Control | New-onset AF | Control | |
Walkey et al. [25] | 74, 44 % | 66, 49 % | Hypertension: 46 % | Hypertension: 48 % |
Diabetes mellitus: 28 % | Diabetes mellitus: 34 % | |||
CAD: 6 % | CAD: 5 % | |||
Stroke: 4 % | Stroke: 2 % | |||
CHF: 11 % | CHF: 6 % | |||
COPD: 7 % | COPD: 5 % | |||
Wells et al. [26] | 72, 41 % | 62, 45 % | CAD: 40 % | CAD: 19 % |
COPD: 39 % | COPD: 29 % | |||
Diabetes Mellitus: 41 % | Diabetes Mellitus: 33 % | |||
Kumar et al. [22] | n/a | n/a | n/a | n/a |
Meierhenrich et al. [23] | 66, 22 % | 56, 44 % | Hypertension: 74 % | Hypertension: 41 % |
CAD: 22 % | CAD: 7 % | |||
CHF: 4 % | CHF: 0 % | |||
COPD: 17 % | COPD: 4 % | |||
Goodman et al. [12] | 69, 50 % | 53, 42 % | Hypertension: 35 % | Hypertension: 14 % |
Diabetes mellitus: 37 % | Diabetes mellitus: 7 % | |||
CAD: 31 % | CAD: 35 % | |||
CHF: 4 % | CHF: 15 % | |||
COPD: 7 % | COPD: 23 % | |||
Salman et al. [19] | 67, 28 % | 56, 50 % | Hypertension: 44 % | Hypertension: 38 % |
Diabetes mellitus: 16 % | Diabetes mellitus: 27 % | |||
CAD: 8 % | CAD: 4 % | |||
Stroke: 8 % | Stroke: 4 % | |||
COPD: 4 % | COPD: 2 % | |||
Christian et al. [20] | 66 | 62.2 | n/a | n/a |
Seguin et al. [24] | 57, 13 % | 41, 24 % | Hypertension: 6 % | Hypertension: 10 % |
CAD: 6 % | CAD: 3 % | |||
Chronic lung disease: 6 % | Chronic lung disease: 4 % |
Author (year) | Significant results | ||
---|---|---|---|
Walkey et al. [25] | New-onset AF in sepsis vs. sepsis alone | In-hospital ischaemic stroke | OR 2.70 (2.05–3.57, p < 0.001) |
In-hospital mortality | RR 1.07 (1.04–1.11, p < 0.001) | ||
Wells et al. [26] | New-onset AF in sepsis vs. sepsis alone | In-hospital mortality | 72 % vs 57 %, p < 0.0001 |
Kumar et al. [22] | New-onset AF In-hospital mortality of new-onset AF and severe sepsis or septic shock vs. severe sepsis or septic shock alone | Frequency in severe sepsis | OR 1.1 (1.13–1.19, p < 0.05) |
Frequency in septic shock | OR 1.33 (1.29–1.37, p < 0.05) | ||
Severe sepsis | OR 1.19 (1.14–1.24, p < 0.05) | ||
Septic shock | OR 1.12 (1.07–1.18, p < 0.05) | ||
Meierhenrich et al. [23] | New-onset AF in severe sepsis vs. sepsis alone | ICU mortality | 39 % vs. 22 %, p = 0.14 |
28-day mortality | 39 % vs. 22 %, p = 0.22 | ||
60-day mortality | 48 % vs. 26 %, p = 0.14 | ||
Median ICU LOS (days) | 30 vs. 17, p = 0.017 | ||
Goodman et al. [12] | New-onset SVA and sepsis vs. sepsis alone | In-hospital mortality | OR 1.99 (1.09–3.64, p = 0.026) |
Salman et al. [19] | Paroxysmal AF and sepsis vs. sepsis alone | ICU mortality | 48 % vs. 27 %, p = 0.0614 |
In-hospital mortality | 64 % vs. 36 %, p = 0.018 | ||
28-day mortality | 72 % vs. 38 %, p = 0.041 | ||
Median ICU LOS (days) | OR 3.284 (1.126–9.574, p = 0.0294) 8 vs. 3, p = 0.0087 | ||
Christian et al. [20] | New-onset AF and sepsis vs. sepsis alone | ICU mortality | 68.8 % vs. 39.8 %, p = 0.034 |
Median ICU LOS (days) | 27.8 vs. 7.6, p = 0.0001 | ||
Hospital LOS (days) | 63.4 vs. 29.4, p = 0.047 | ||
Mechanical ventilation (days) | 23.58 vs. 8.35, p = 0.006 | ||
Seguin et al. [24] | New-onset AF and sepsis vs. sepsis alone | In-hospital mortality | 25 % vs. 11 % |