Department of Cardiology, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Department of Geriatrics, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Am J Emerg Med. 2021 Apr;42:23-30. doi: 10.1016/j.ajem.2020.12.062. Epub 2021 Jan 5.
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.
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.
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.
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.
脓毒症患者新发心房颤动（AF）的结局不一致且尚无定论。本荟萃分析旨在全面描述新发 AF 对脓毒症患者预后的影响。
检索 3 个电子数据库（PubMed、Embase 和 Cochrane Library），寻找相关研究。使用比值比（OR）和 95%置信区间（CI）作为效应量进行荟萃分析。
共纳入来自 13 项研究的 225841 例患者进行荟萃分析。汇总结果表明，脓毒症患者新发 AF 与住院期间死亡率（合并 OR：2.09；95%CI：1.53-2.86；p<001）、出院后死亡率（合并 OR：2.44；95%CI：1.81-3.29；p<0.001）和卒中（合并 OR：1.88；95%CI：1.13-3.14；p<.05）的发生风险增加相关。此外，新发 AF 的发生率从轻度脓毒症的 1.9%到感染性休克的 46.0%不等。与无 AF 患者相比，新发 AF 患者 ICU 入住时间和住院时间更长，AF 复发率更高。
脓毒症患者新发 AF 常与不良预后相关。这是一个需要引起更多关注的临床问题，应适当管理以预防不良预后。
