Ricerc@Sapienza

Background: Sepsis is a life-threatening organ dysfunction, which still represent one major cause of death worldwide. Atrial fibrillation (AF) often occur during sepsis, and imposes additional treatments, longer hospital stay, and an increased risk of mortality and morbidity.
Current knowledge on the relationship between sepsis and AF is limited. Beyond uncertainties on the pathophysiological mechanisms, the epidemiology and natural history of sepsis-related AF is still unknown, both in terms of prevalence of AF, and the magnitude of its effects on the prognosis of sepsis patients.
We aim to estimate the prevalence of AF, and the AF-associated risk of adverse events (all-cause mortality, thromboembolism and major bleeding) among patients with sepsis or septic shock, through a systematic review and meta-analysis of the literature. Furthermore, using advanced meta-regression techniques, we aim to identify factors associated with the onset of sepsis-related AF, and the AF-associated risk of outcomes.

Methods: This study will be performed according to the MOOSE and PRISMA Guidelines. Two investigators will independently perform the study selection process, bias assessment, and data extraction. We will report pooled estimates for 1) the prevalence of sepsis-related AF, and 2) the risk of outcomes according to the presence of AF. Finally, meta-regression analyses will be performed to identify factors associated with increased risk of AF and outcomes.

Discussion: The results of our analysis will provide a benchmark on the epidemiology of sepsis-related AF, with an effective and innovative use of the currently available data. Meta-regressions are expected to identify factors responsible for the onset of sepsis-related AF and worse progonsis, and these findings will provide a solid ground for the design of future studies and the development of specific preventive and treatment strategies, ultimately improving the care of sepsis patients.