{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T12:06:25Z","timestamp":1792411585969,"version":"4.4.0"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Practice 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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Retrospective, observational cohort study of patients \u226540 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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Among 82\u2009748 patients hospitalized with sepsis, 3992 (4.8%) had new-onset AF and survived to hospital discharge; mean age was 78\u00b111 years, 53% were men, and 70% were White. Patients with new-onset AF during sepsis averaged 45\u00b133% 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\u20136.38]) and no significant difference in 1-year adjusted risks of major bleeding (6.51% versus 7.10%; risk difference, \u22120.59% [95% CI, \u22123.09 to 1.91]). Sensitivity analysis of ischemic stroke\u2013only outcomes showed a risk difference of 0.15% (95% CI, \u22121.72 to 2.03).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>After 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.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.122.009494","type":"journal-article","created":{"date-parts":[[2023,3,5]],"date-time":"2023-03-05T10:00:27Z","timestamp":1678010427000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Practice Patterns and Outcomes Associated With Anticoagulation Use Following Sepsis Hospitalizations With New-Onset Atrial Fibrillation"],"prefix":"10.1161","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4685-6894","authenticated-orcid":true,"given":"Allan J.","family":"Walkey","sequence":"first","affiliation":[{"name":"Section of Pulmonary, Allergy, Critical Care, Department of Medicine, Boston University School of Medicine, MA (A.J.W., Y.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura C.","family":"Myers","sequence":"additional","affiliation":[{"name":"The Permanente Medical Group, Oakland, CA (L.C.M., A.S.G., V.X.L.)."},{"name":"Division 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.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5958-6585","authenticated-orcid":true,"given":"Khanh K.","family":"Thai","sequence":"additional","affiliation":[{"name":"Division 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.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4572-0178","authenticated-orcid":true,"given":"Patricia","family":"Kipnis","sequence":"additional","affiliation":[{"name":"Division 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.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6949-2651","authenticated-orcid":true,"given":"Manisha","family":"Desai","sequence":"additional","affiliation":[{"name":"Biomedical Informatics Department (M.D.), Stanford University, Palo Alto, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9109-0811","authenticated-orcid":true,"given":"Alan S.","family":"Go","sequence":"additional","affiliation":[{"name":"The Permanente Medical Group, Oakland, CA (L.C.M., A.S.G., V.X.L.)."},{"name":"Division 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.)."},{"name":"Department of Medicine (A.S.G.), Stanford University, Palo Alto, CA."},{"name":"Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA (A.S.G., R.N.)."},{"name":"Departments of Medicine (A.S.G.), University of California, San Francisco."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0900-4249","authenticated-orcid":true,"given":"Yun","family":"Lu","sequence":"additional","affiliation":[{"name":"Division 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.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Clancy","sequence":"additional","affiliation":[{"name":"Division 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.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ycar","family":"Devis","sequence":"additional","affiliation":[{"name":"Section of Pulmonary, Allergy, Critical Care, Department of Medicine, Boston University School of Medicine, MA (A.J.W., Y.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Neugebauer","sequence":"additional","affiliation":[{"name":"Division 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.)."},{"name":"Department of Health Systems Science, Kaiser Permanente Bernard J. 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