Sepsis may be nontraditional risk factor for HF, rehospitalization

adults who survive hospitalized for sepsis The risk of cardiovascular events leading to post-hospital death and hospitalization is significantly increased, researchers report.

In a database analysis of more than 2.2 million patients, the researchers also found a particularly high excess risk for sepsis patients. hospitalized in HF, showed a more than 50% increase in risk during follow-up, according to Jacob C. JenzerMD, He is the Director of Research for the Cardiac Intensive Care Unit and an Assistant Professor of Cardiology at the Mayo Clinic.

“Providers caring for sepsis survivors during and after hospitalization should ensure that these patients receive appropriate medications to prevent cardiovascular events based on their known disease and risk factors, and that cardiovascular prophylactic drugs are unnecessary or unnecessary. We need to provide close follow-up to avoid inadvertent cancellations and to monitor for the development of new CV events,” Jentzer told Healio.

Links between sepsis and CV events

Using data from the OptumLabs Data Warehouse, Jentzer and colleagues analyzed data from 2,258,464 adults who survived a nonsurgical hospital stay requiring at least a two-night stay between 2009 and 2019. The researchers assessed the association between sepsis during hospitalization and subsequent death and readmission using Kaplan-Meier survival analysis and multivariable Cox proportional hazards models.

The survey results are Journal of the American Heart Association.

The researchers found that 35.8% of patients were hospitalized for sepsis during the study period, which consisted of post-discharge follow-up over 5,396,051 patient-years. This includes only 448,644 with occult sepsis and 124,841 with overt sepsis, both in her 235,188.

Hospitalized sepsis patients had a 27% higher risk of all-cause mortality (adjusted HR = 1.27; 95% CI, 1.25–1.28; P. .001), with a 38% increased risk of all-cause readmission (aHR = 1.38; 95% CI, 1.37-1.39; P. .001) and 43% increased risk of CV hospitalization (aHR = 1.43; 95% CI, 1.41-1.44; P. .001).

Patients with sepsis had a particularly high risk of HF hospitalization (aHR = 1.51; 95% CI 1.49-1.53). Patients with occult sepsis were at higher risk than those with overt sepsis, according to the researchers.

The researchers noted that the excess risk of cardiovascular events in sepsis survivors was large enough that sepsis should be considered a non-traditional risk factor for cardiovascular events.

“It is imperative to determine which prophylactic agents, if any, can reduce the risk of future cardiovascular events in sepsis survivors. Is this an escalation or adjustment of existing cardiovascular prophylactic therapy?” , whether in addition to established or novel preventative therapies,” Jentzer told Healio.

Recognizing the burden of sepsis after hospital discharge

In a related editorial, Gabriel WardiMD, MPH, An associate professor of clinical emergency services at UC San Diego Health and a colleague wrote that they had questions about the findings. However, the data should alert providers to the importance of the sepsis episode as a major event in patient history.

“Rapid attention and recognition of the post-discharge burden of sepsis, coupled with meticulous post-discharge care and cardiovascular risk stratification, could potentially improve patient-centered outcomes. ‘ write Wardi and colleagues. “Future clinical investigations should include different groups of individuals to assess whether sepsis is truly an independent cardiovascular risk factor and how interventions influence these outcomes. .”

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Jacob C. JenzerMD, You can contact me at [email protected]