Atrial Fibrillation and Sepsis in Elderly Patients and Their Associaton with In-Hospital Mortality

Abstract

Background

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.

Objectives

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.

Methods

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%.

Results

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])

Conclusion

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.

Arrhythmias, Cardiac; Atrial Fibrillation; Sepsis; Hospitalization; Hospital Mortality