Sepsis is a leading cause of hospitalization, disability and death worldwide. Despite improvements in recognition and management of patients with sepsis, short-term mortality in this group remains high. Survivors of hospitalization for sepsis remain at high risk of death and other adverse clinical events.
cardiovascular disease (CVD) is increasingly recognized as a risk factor for sepsis and a potential consequence of sepsis. Previous studies have observed an association between sepsis and excess risk of cardiovascular events after hospital discharge. However, a recent meta-analysis of observational studies found low-quality evidence to support this association due to methodological limitations of the published studies.
In a new study, scientists investigated whether adults with sepsis had an increased risk of dying after hospital discharge and an increased risk of being readmitted for cardiovascular events. sepsispatients discharged after hospitalization involving sepsis were at increased risk of cardiovascular events, readmission for any reason, or death at up to 12 years of follow-up.
The researchers searched a database of administrative claims data. They found more than 2 million Medicare Advantage and commercial policyholders nationwide who endured a nonsurgical hospitalization lasting at least two nights between 2009 and 2019. Medical claims show that more than 800,000 patients between the ages of 19 and 87 developed sepsis while in hospital. During a follow-up period from 2009 to 2021, researchers examined the relationship between hospitalization and sepsis, readmission, and death.
The researchers included explicit and implicit sepsis diagnostic codes because discrepancies in the diagnosis and documentation of sepsis can influence research outcomes and clinical treatment outcomes. If the patient has detailed sepsis, a doctor makes a formal diagnosis.
The commonly accepted definition, occult sepsis, is an electronic health record control code that is automatically assigned when a patient has both an infection and organ failure. Patients were classified as having or not having sepsis based on whether they met any criteria for sepsis.
To focus on the potential cardiovascular effects of sepsis, the researchers analyzed 808,673 hospitalized patients who developed sepsis and those who did not develop sepsis but had cardiovascular disease or one or more We compared 1,449,821 hospitalized patients with disease risk factors.
The findings showed that patients with sepsis were 27% more likely to die and 38% more likely to be readmitted for any cause, especially those who returned to hospital, compared to those who did not have sepsis during hospitalization. suggests a 43% chance. For cardiovascular reasons 12 years after having sepsis.
The lead study author, Jacob C. Jentzer, MD, FAHA, is an assistant professor of cardiology at the Mayo Clinic, Rochester, Minnesota. Said, “Our findings demonstrate the importance of close follow-up care after hospitalization for sepsis. Experts recognize that people who have previously had sepsis are at very high risk of cardiovascular events and may need to be advised to increase the intensity of cardiovascular prophylaxis. is needed.”
Journal reference:
- Jacob C. Jenzer et al. Cardiovascular events in survivors of sepsis hospitalization: a retrospective cohort analysis. American Heart Association JournalDoi: 10.1161/JAHA.122.027813