Key result
Among patients developing new-onset atrial fibrillation during sepsis, only 25% were discharged on warfarin and 44% received no anticoagulation, a trend that persisted at one-year follow-up.
Why the study?
To investigate anticoagulation practice and factors associated with new-onset atrial fibrillation in patients with sepsis and septic shock, with one-year follow-up after discharge.
Cohort (n=120)
No
A significant proportion of patients developing new-onset atrial fibrillation during sepsis do not receive anticoagulation at discharge or at one-year follow-up, indicating a need for standardized guidelines.
Under-anticoagulation after sepsis-associated NOAF is common; leaves open optimal long-term strategies pending prospective data.
Objective To investigate the anticoagulation practice in patients presenting with new-onset atrial fibrillation (NOAF) during sepsis and septic shock with one-year follow-up since discharge and to evaluate factors associated with the development of NOAF. Methods A retrospective observational cohort study was conducted using chart review in patients diagnosed with sepsis and septic shock. Results There was a total of 1132 patients diagnosed with sepsis and septic shock over a one-year period. Thirty-two patients were found to have NOAF in the setting of sepsis. Of this, eight (25%) patients were anticoagulated with warfarin and 14 (44%) patients were not anticoagulated during discharge. At one-year follow-up post-discharge, nine (29%) patients continued on warfarin and 16 (52%) patients remained not anticoagulated. Conclusion We found that the majority of patients who developed NOAF did not get anticoagulated at the time of discharge. A similar trend followed after one year of follow-up. Since proper treatment guidelines are not in place, these patients are at high risk for recurrent atrial fibrillation, stroke, transient ischemic attack, and death.
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Arunachalam et al. (2020) conducted a cohort in Sepsis and septic shock (n=120). New-onset atrial fibrillation vs. No atrial fibrillation was evaluated on Anticoagulation with warfarin at discharge. Among patients developing new-onset atrial fibrillation during sepsis, only 25% were discharged on warfarin and 44% received no anticoagulation, a trend that persisted at one-year follow-up.
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