{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T13:27:36Z","timestamp":1780752456704,"version":"3.54.1"},"reference-count":22,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T00:00:00Z","timestamp":1712620800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>New\u2010onset atrial fibrillation (AF) during sepsis is common, but models designed to stratify stroke risk excluded patients with secondary AF. We assessed the predictive validity of CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>VASc scores among patients with new\u2010onset AF during sepsis\u00a0and developed a novel stroke prediction model incorporating presepsis and intrasepsis characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included patients \u226540 years old who survived hospitalizations with sepsis and new\u2010onset AF across 21 Kaiser Permanente Northern California hospitals from January 1, 2011 to September 30, 2017. We calculated the area under the receiver operating curve (AUC) for CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>VASc scores to predict stroke or transient ischemic attack (TIA) within 1 year after a hospitalization with new\u2010onset AF during sepsis using Fine\u2010Gray models with death as competing risk. We similarly derived and validated a novel model using presepsis and intrasepsis characteristics associated with 1\u2010year stroke\/TIA risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 82,748 adults hospitalized with sepsis, 3992 with new\u2010onset AF (median age: 80 years, median CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>VASc of 4) survived to discharge, among whom 70 (2.1%) experienced stroke or TIA outcome\u00a0and 1393 (41.0%) died within 1 year of sepsis. The CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>VASc score was not predictive of stroke risk after sepsis (AUC: 0.50, 95% confidence interval [CI]: 0.48\u20130.52). A newly derived model among 2555 (64%) patients in the derivation set and 1437 (36%) in the validation set included 13 variables and produced an AUC of 0.61 (0.49\u20130.73) in derivation and 0.54 (0.43\u20130.65) in validation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Current models do not accurately stratify risk of stroke following new\u2010onset AF secondary to sepsis. New tools are required to guide anticoagulation decisions following new\u2010onset AF in sepsis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhm.13343","type":"journal-article","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T01:19:50Z","timestamp":1712711990000},"page":"565-571","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Predicting stroke risk after sepsis hospitalization with new\u2010onset atrial fibrillation"],"prefix":"10.1002","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2872-3388","authenticated-orcid":false,"given":"Laura C.","family":"Myers","sequence":"first","affiliation":[{"name":"The Permanente Medical Group, Kaiser Permanente Northern California Oakland California USA"},{"name":"Division of Research Kaiser Permanente Northern California Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ithan D.","family":"Peltan","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine Intermountain Medical Center Murray Utah USA"},{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine University of Utah School of Medicine Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khanh K.","family":"Thai","sequence":"additional","affiliation":[{"name":"The Permanente Medical Group, Kaiser Permanente Northern California Oakland California USA"},{"name":"Division of Research Kaiser Permanente Northern California Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Kipnis","sequence":"additional","affiliation":[{"name":"The Permanente Medical Group, Kaiser Permanente Northern California Oakland California USA"},{"name":"Division of Research Kaiser Permanente Northern California Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manisha","family":"Desai","sequence":"additional","affiliation":[{"name":"Biomedical Informatics Department Stanford University Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ycar","family":"Devis","sequence":"additional","affiliation":[{"name":"Section of Pulmonary, Critical Care, Allergy, Sleep Medicine, Department of Medicine,\u00a0 The Pulmonary Center Boston University School of Medicine Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Clancy","sequence":"additional","affiliation":[{"name":"The Permanente Medical Group, Kaiser Permanente Northern California Oakland California USA"},{"name":"Division of Research Kaiser Permanente Northern California Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun W.","family":"Lu","sequence":"additional","affiliation":[{"name":"The Permanente Medical Group, Kaiser Permanente Northern California Oakland California USA"},{"name":"Division of Research Kaiser Permanente Northern California Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel M.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine Intermountain Medical Center Murray Utah USA"},{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine University of Utah School of Medicine Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan S.","family":"Go","sequence":"additional","affiliation":[{"name":"The Permanente Medical Group, Kaiser Permanente Northern California Oakland California USA"},{"name":"Division of Research Kaiser Permanente Northern California Oakland California USA"},{"name":"Department of Health Systems Science Kaiser Permanente Bernard J. Tyson School of Medicine Pasadena California USA"},{"name":"Department of Epidemiology and Biostatistics and Department of Medicine University of California, San Francisco San Francisco California USA"},{"name":"Department of Medicine Stanford University School of Medicine Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain S.","family":"Neugebauer","sequence":"additional","affiliation":[{"name":"The Permanente Medical Group, Kaiser Permanente Northern California Oakland California USA"},{"name":"Division of Research Kaiser Permanente Northern California Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent X.","family":"Liu","sequence":"additional","affiliation":[{"name":"The Permanente Medical Group, Kaiser Permanente Northern California Oakland California USA"},{"name":"Division of Research Kaiser Permanente Northern California Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan J.","family":"Walkey","sequence":"additional","affiliation":[{"name":"Section of Pulmonary, Critical Care, Allergy, Sleep Medicine, Department of Medicine,\u00a0 The Pulmonary Center Boston University School of Medicine Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.014058"},{"key":"e_1_2_7_3_1","unstructured":"Centers for Disease Control and Prevention.Atrial Fibrillation. 2022. 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