Evaluation of Anticoagulation Practice With New-Onset Atrial Fibrillation in Patients with Sepsis and Septic Shock in Medical Intensive Care Unit: A Retrospective Observational Cohort Study.

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.