Hospital Sírio-libanês, São Paulo, SP - Brasil.
Universidade do Extremo Sul Catarinense Curso de Medicina, Criciúma, SC - Brasil.
Arq Bras Cardiol. 2023 Mar 10;120(3):e20220295. doi: 10.36660/abc.20220295. eCollection 2023.
Atrial fibrillation (AF) affects about 2% to 4% of the world population, and in patients hospitalized in intensive care units, this incidence can reach up to 23% in those with septic shock. The impact of AF in patients with sepsis is reflected in worse clinical outcomes, and the identification of the triggering factors can be a target for future prevention and treatment strategies.
To verify the relationship between the development of AF and mortality in patients over 80 years of age included in the sepsis protocol and to identify the risk factors that contribute to the development of AF in this population.
Retrospective observational study, with a review of electronic medical records and inclusion of 895 patients aged 80 years or older, included in the sepsis protocol of a high-complexity private hospital in São Paulo, SP, from January 2018 to December 2020. All tests were performed with a significance level of 5%.
The incidence of AF in the sample was 13%. After multivariate analysis, using multiple logistic regression, it was possible to demonstrate an association of mortality, in the studied population, with the SOFA score (odds ratio [OR] 1.21 [1.09 - 1.35]), higher values of C-reactive protein (OR 1.04 [1.01 - 1.06]), need for vasoactive drugs (OR 2.4 [1.38 - 4.18]), use of mechanical ventilation (OR 3.49 [1.82 - 6.71]), and mainly AF (OR 3.7 [2.16 - 6.31]).
In very elderly patients (80 years of age and older) with sepsis, the development of AF was shown to be an independent risk factor for in-hospital mortality.
心房颤动（AF）影响全球约 2%至 4%的人口，在重症监护病房住院的患者中，败血性休克患者的发病率可达 23%。AF 在脓毒症患者中的影响反映在更差的临床结局上，识别触发因素可能是未来预防和治疗策略的目标。
验证纳入脓毒症方案的 80 岁以上患者中 AF 发展与死亡率之间的关系，并确定导致该人群 AF 发展的危险因素。
回顾性观察性研究，回顾电子病历，并纳入 2018 年 1 月至 2020 年 12 月期间在圣保罗一家高复杂度私立医院纳入脓毒症方案的 895 名 80 岁或以上的患者。所有测试的显著性水平均为 5%。
样本中 AF 的发生率为 13%。经过多变量分析，使用多元逻辑回归，表明在研究人群中，死亡率与 SOFA 评分（优势比 [OR] 1.21 [1.09 - 1.35]）、C 反应蛋白值升高（OR 1.04 [1.01 - 1.06]）、血管活性药物需求（OR 2.4 [1.38 - 4.18]）、机械通气使用（OR 3.49 [1.82 - 6.71]）和主要的 AF（OR 3.7 [2.16 - 6.31]）有关。
在患有脓毒症的非常高龄（80 岁及以上）患者中，AF 的发展被证明是住院死亡率的独立危险因素。
