New-onset atrial fibrillation-related ischemic stroke occurring after hospital discharge in septicemia survivors.
BACKGROUND
Sepsis will induce stroke, new-onset atrial fibrillation (AF) increase ischemic stroke (IS) in in-hospitalization and long-term period after sepsis. Physicians must alert this condition and given suitable treatment.


OBJECTIVE
The associated of IS and new-onset AF in septicemia survivors after discharge have to be evaluated.


METHODS
The inpatient data was used of the Taiwan National Health Insurance Database (NHIRD) in 2010. We identified patients suffered their first occurrence of septicemia (International Classification of Disease, Ninth Revision, Clinical Modification [ICD-9-CM] is 038, 003.1, 036.1) and excluded less than 18 years old. Patients had AF (ICD-9-CM to 427.3×) during the same admission or after septicemia hospitalization discharged were defined as new-onset AF. The outcome was IS happened after septicemia discharge (ICD-9-CM as 433-437).


METHODS
The factors related to IS after septicemia survival were established using multivariate logistic regression with forward stepwise selection.


RESULTS
There were 1286 new-onset AF and 1026 IS happened after septicemia discharge. The crude odds ratio (OR) were 3.88 (95% confidence interval [C.I.]: 1.69-8.89) and 1.62 (95% C.I.: 1.14-2.3) in middle-aged and elderly septicemia survivors with new-onset AF induced IS. The risk of IS after septicemia survivors was noticed adjusted OR 1.74 (95% C.I.: 1.26-2.41) for new-onset AF.


CONCLUSIONS
The middle-aged and elderly septicemia survivors suffered from new-onset AF had increased incidence of IS within three months. New-onset AF was a mediator factor of IS in septicemia survivors of Asian population.
Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.|Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan.
C-A
CA
Cheng
Department of Emergency, Armed Taoyuan General Hospital, Taoyuan, Taiwan.|Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
C-G
CG
Cheng
Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
H-C
HC
Lin
Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
J-T
JT
Lee
Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
H-C
HC
Lin
Department of Cardiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
C-C
CC
Cheng
Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.|School of Public Health, National Defense Medical Center, Taipei, Taiwan.
W-C
WC
Chien
Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan.
H-W
HW
Chiu
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000453:epidemiology*; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010351:Patient Discharge; D012307:Risk Factors; D018805:Sepsis / Q000150:complications*; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology; D017741:Survivors / Q000706:statistics & numerical data; D013624:Taiwan / Q000453:epidemiology