Evidence map›Paper›PMID 36852680›Full record

Observational studyCirculation. Cardiovascular quality and outcomes2023

Practice Patterns and Outcomes Associated With Anticoagulation Use Following Sepsis Hospitalizations With New-Onset Atrial Fibrillation.

Allan J Walkey, Laura C Myers, Khanh K Thai, Patricia Kipnis, Manisha Desai, Alan S Go, Yun Lu, Heather Clancy, Ycar Devis, Romain Neugebauer and 1 more

Open access · bronzeAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Circulation. Cardiovascular quality and outcomes, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
6.0field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 28 citations in OpenAlex.

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  7. Anticoagulation and thromboembolic risk in critically ill patients with trigger-induced atrial fibrillation-A systematic review and meta-analysis.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

Allan J WalkeySection of Pulmonary, Allergy, Critical Care, Department of Medicine, Boston University School of Medicine, MA (A.J.W., Y.D.).ORCID 0000-0003-4685-6894
Laura C MyersThe Permanente Medical Group, Oakland, CA (L.C.M., A.S.G., V.X.L.).
Khanh K ThaiDivision of Research, Kaiser Permanente Northern California, Oakland (L.C.M., K.K.T., P.K., A.S.G., Y.W.L., H.C., R.N., V.X.L.).ORCID 0000-0001-5958-6585
Patricia KipnisDivision of Research, Kaiser Permanente Northern California, Oakland (L.C.M., K.K.T., P.K., A.S.G., Y.W.L., H.C., R.N., V.X.L.).ORCID 0000-0003-4572-0178
Manisha DesaiBiomedical Informatics Department (M.D.), Stanford University, Palo Alto, CA.ORCID 0000-0002-6949-2651
Alan S GoThe Permanente Medical Group, Oakland, CA (L.C.M., A.S.G., V.X.L.).ORCID 0000-0001-9109-0811
Yun LuDivision of Research, Kaiser Permanente Northern California, Oakland (L.C.M., K.K.T., P.K., A.S.G., Y.W.L., H.C., R.N., V.X.L.).ORCID 0000-0002-0900-4249
Heather ClancyDivision of Research, Kaiser Permanente Northern California, Oakland (L.C.M., K.K.T., P.K., A.S.G., Y.W.L., H.C., R.N., V.X.L.).
Ycar DevisSection of Pulmonary, Allergy, Critical Care, Department of Medicine, Boston University School of Medicine, MA (A.J.W., Y.D.).
Romain NeugebauerDivision of Research, Kaiser Permanente Northern California, Oakland (L.C.M., K.K.T., P.K., A.S.G., Y.W.L., H.C., R.N., V.X.L.).
Vincent X LiuThe Permanente Medical Group, Oakland, CA (L.C.M., A.S.G., V.X.L.).
Kaiser Permanente · USPulmonary and Allergy Associates · USColorado Permanente Medical Group · USPalo Alto University · US

Funding

Translational Research Core - Health Engagement & Action Translational (HEAT)P30DK092924 · NIDDK · KAISER FOUNDATION RESEARCH INSTITUTE · PI Alyce Sophia Adams, HILARY Kessler SELIGMAN · 2011 to 2026
$9.2M
Targeting cardiovascular events to improve patient outcomes after sepsisR01HL139751 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI WALKEY, ALLAN J. · 2018 to 2021
$2.8M
NHLBI NIH HHS R01 HL139751NIDDK NIH HHS P30 DK092924
6 · The paper itself

Abstract

backgroundPractice patterns and outcomes associated with the use of oral anticoagulation for arterial thromboembolism prevention following a hospitalization with new-onset atrial fibrillation (AF) during sepsis are unclear.

methodsRetrospective, observational cohort study of patients ≥40 years of age discharged alive following hospitalization with new-onset AF during sepsis across 21 hospitals in the Kaiser Permanente Northern California health care delivery system, years 2011 to 2018. Primary outcomes were ischemic stroke/transient ischemic attack (TIA), with a safety outcome of major bleeding events, both within 1 year of discharge alive from sepsis hospitalization. Adjusted risk differences for outcomes between patients who did and did not receive oral anticoagulation within 30 days of discharge were estimated using marginal structural models fitted by inverse probability weighting using Super Learning within a target trial emulation framework.

resultsAmong 82 748 patients hospitalized with sepsis, 3992 (4.8%) had new-onset AF and survived to hospital discharge; mean age was 78±11 years, 53% were men, and 70% were White. Patients with new-onset AF during sepsis averaged 45±33% of telemetry monitoring entries with AF, and 27% had AF present on the day of hospital discharge. Within 1 year of hospital discharge, 89 (2.2%) patients experienced stroke/TIA, 225 (5.6%) had major bleeding, and 1011 (25%) died. Within 30 days of discharge, 807 (20%) patients filled oral anticoagulation prescriptions, which were associated with higher 1-year adjusted risks of ischemic stroke/TIA (5.69% versus 2.32%; risk difference, 3.37% [95% CI, 0.36-6.38]) and no significant difference in 1-year adjusted risks of major bleeding (6.51% versus 7.10%; risk difference, -0.59% [95% CI, -3.09 to 1.91]). Sensitivity analysis of ischemic stroke-only outcomes showed a risk difference of 0.15% (95% CI, -1.72 to 2.03).

conclusionsAfter hospitalization with new-onset AF during sepsis, oral anticoagulation use was uncommon and associated with potentially higher stroke/TIA risk. Further research to inform mechanisms of stroke and TIA and management of new-onset AF after sepsis is needed.

Indexed as

Atrial FibrillationIschemic Attack, TransientIschemic StrokeSepsisStrokeAdultAgedAged, 80 and overAnticoagulantsFemaleHemorrhageHospitalizationHumansMaleRetrospective StudiesRisk FactorsAnticoagulantsarrhythmiascardiachumansprobabilitysepsistelemetry

Identifiers

PMID36852680
PMCPMC10033425
OpenAlexW4322617682

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.