Sepsis increases risk of heart failure and readmission after hospital discharge

Sepsis is a leading cause of hospitalization and death worldwide. Approximately 1.7 million people develop sepsis in the United States each year. Sepsis is an extreme immune response to an infection in the blood that can spread throughout the body, leading to organ failure and death.

“We know that infection can potentially trigger myocardial infarction and heart attack. We also know that infection can occur directly during infection, or afterward, when the infection and its effects on the body can lead to progressive cardiovascular disease.” We know that we may predispose patients to other cardiovascular events when we promote ,” said lead study author Jacob C., assistant professor of medicine, Department of Cardiology, Mayo Clinic, Rochester, Minnesota. Jenzer, M.D., FAHA, said: “We sought to explain the association between sepsis during hospitalization and subsequent death and readmission in a large group of adults.”

In this study, researchers investigated whether adults with sepsis had an increased risk of death after hospital discharge and readmission due to cardiovascular events. They queried a database containing government claims data and found that between 2009 and 2019 he survived two or more nonsurgical hospital stays, and his 2 million people with corporate and Medicare Advantage insurance across the country. identified more than one participant. Of these patients, aged 19 to 87, medical claims indicate that he contracted sepsis more than 800,000 while hospitalized. The researchers analyzed the association between hospitalization and sepsis, readmission, and death during follow-up from 2009 to 2021.

Because differences in diagnosing and documenting sepsis can influence research and clinical treatment outcomes, researchers should include two standard diagnostic codes (explicit and implicit) used for sepsis. I was. Overt sepsis means that the doctor duly diagnosed the patient. Occult sepsis, an electronic health record control code automatically given when a patient has both an infection and organ failure, is the currently accepted definition of sepsis. The presence of any definition of sepsis was used to classify patients with and without sepsis.

To focus on the potential cardiovascular effects of sepsis, the researchers studied 808,673 hospitalized patients who developed sepsis and those who did not develop sepsis but had cardiovascular disease or more than one cardiovascular disease. (older age, hypertension, hyperlipidemia, type 2 diabetes, chronic kidney disease, obesity or smoking).

result of analysis:

• Compared with patients who did not have sepsis during hospitalization, patients with sepsis were 27% more likely to die, 38% more likely to be readmitted from any cause, and to be hospitalized, especially for cardiovascular causes. 43% more likely to return to 12 years after sepsis.
• Heart failure was the most common major cardiovascular event (including stroke, heart attack, arrhythmia, and heart failure) among sepsis patients. Those who had sepsis while hospitalized had a 51% higher risk of developing heart failure during follow-up.
• Patients with occult sepsis (infection due to organ failure) were twice as likely to be readmitted to cardiovascular events compared with those with overt sepsis (formal diagnosis by a physician).

“Our findings demonstrate the importance of close follow-up care after hospitalization for sepsis and the value of implementing cardiovascular prophylaxis under close supervision.” should be aware that people who have previously had sepsis are at very high risk for cardiovascular events and may need to be advised to increase the intensity of cardiovascular prophylaxis.”

The study authors will continue to evaluate new data on people who have previously had sepsis during hospitalization to clarify the need for cardiovascular prophylaxis. “This is an important opportunity for people who have had sepsis to establish what works and what doesn’t in the future,” said Jentzer.

The main limitation of this study is that it is a retrospective cohort study using data collected through hospital administration. This meant that the researchers were assessing historical records and had no information on sepsis severity.

Co-authors are Patrick R. Lawler, MD, MPH. Holly K. Van Houten, BA. Xiaoxi Yao, Ph.D., MPH. Kianoush B. Kashani, MD, MS. and Shannon M. Dunlay, MD, MS Author disclosures are provided in the manuscript.

This research was supported by the Mayo Clinic Robert D. and Patricia E. Kern Health Care Delivery Science Center and the Mayo Clinic Cardiovascular Medicine Division.