Intersection of sepsis, atrial fibrillation, and severe obesity: a population-based analysis in the United States
Authors' conclusion
A higher prevalence of cardiovascular comorbidities can be linked to a higher risk of AF in people with obesity and sepsis. Paradoxically, lower rates of stroke and all-cause mortality secondary to AF in people with obesity and sepsis warrant further investigation.
Study context
- Population
- Principal sepsis admissions in the US, National Inpatient Sample (2018)
- Participants
- 1,345,595 sepsis admissions
- Exposure
- Severe obesity and non-severe obesity vs no obesity in sepsis admissions
- Outcome
- Prevalence and adjusted odds of AF, AF-associated stroke and all-cause mortality in sepsis by obesity status
- Follow-up
- In-hospital
Methodological detailspopulation-based, National Inpatient Sample (2018), ICD-10 CM codes, multivariable regression adjusted for patient- and hospital-level characteristics and comorbidities, subgroup analysis by metabolic health
- Population-based
- National Inpatient Sample (2018)
- ICD-10 CM codes
- Multivariable regression adjusted for patient- and hospital-level characteristics and comorbidities
- Subgroup analysis by metabolic health
Main finding
As reported in the abstract
AF, AF-associated stroke and in-hospital all-cause mortality
Without obesity
- Atrial fibrillation (AF)-associated stroke rate
- 1.7%
- In-hospital mortality
- 7.1%
Non-severe obesity
- Crude AF prevalence (highest)
- 19.9%
- AF-associated stroke rate
- 1.5%
- In-hospital mortality
- 4.9%
Severe obesity
- AF-associated stroke rate
- 1%
- In-hospital mortality
- 3.3%
Atrial fibrillation (AF)-associated stroke rate
Without obesity1.7%
Non-severe obesity1.5%
Severe obesity1%
In-hospital mortality
Without obesity7.1%
Non-severe obesity4.9%
Severe obesity3.3%
Crude AF prevalence (highest)
Without obesity— not stated in the abstract
Non-severe obesity19.9%
Severe obesity— not stated in the abstract
Each group vs without obesityEstimate (95% CI)P value
Non-severe obesity
aOR of AF 1.21(1.16–1.27)
P < 0.001Severe obesity
aOR of AF 1.49(1.43–1.55)
P < 0.001Severe obesity
aOR of all-cause mortality (sepsis-AF) 0.78(0.67–0.91)
Non-severe obesity
aOR of all-cause mortality (sepsis-AF) 0.63(0.54–0.74)
Observational data: associations, not effects.
Further findings
Age · baseline
Comorbidities · baseline
- Patients with obesity, often female, more likely to have hypertension, diabetes, congestive HF, chronic pulmonary disease and CKD
Original publication
Intersection of sepsis, atrial fibrillation, and severe obesity: a population-based analysis in the United States. Int J Obes (Lond). Published 28 October 2023. doi:10.
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