Sepsis Raises Odds for Heart Failure After Hospital Discharge
Having sepsis -- a life-threatening response to infection -- may put patients at risk for future heart failure and rehospitalization, according to a new study.
Sepsis is an extreme immune response to an infection in the body. It can cause that infection to spread throughout the body and lead to organ failure and possibly death.
“We know that infection may be a potential trigger for myocardial infarction or heart attack, and infection may also predispose a patient to other cardiovascular events, either directly during infection or later when the infection and related effects on the body promote progressive cardiovascular disease,” said lead study author Dr. Jacob Jentzer.
“We sought to describe the association between sepsis during hospitalization and subsequent death and rehospitalization among a large group of adults,” added Jentzer in an American Heart Association news release. He's an assistant professor of medicine in the department of cardiovascular medicine at the Mayo Clinic in Rochester, Minn.
Compared to people without sepsis during hospitalization, researchers found that people hospitalized for sepsis or who developed it while hospitalized had a 38% higher risk of rehospitalization for all causes over the next 12 years. They also had a 43% higher risk of rehospitalization for cardiovascular causes.
The risk of developing heart failure after discharge was 51% higher in people who had sepsis while hospitalized compared to those who did not have sepsis while hospitalized. Heart failure means the body can't pump blood throughout the body as well as it should.
Those who had sepsis while hospitalized also had a 27% higher risk of death after hospital discharge compared to people without sepsis.
About 1.7 million people develop sepsis in the United States each year.
“Our findings indicate that after hospitalization with sepsis, close follow-up care is important, and it may be valuable to implement cardiovascular prevention therapies with close supervision,” Jentzer said. “Professionals need to be aware that people who have previously had sepsis are at very high risk for cardiovascular events, and that it may be necessary to advise them to increase the intensity of their cardiovascular prevention.”
For the study, researchers looked at claims data for more than 2 million enrollees in commercial and Medicare Advantage insurance plans who had survived a non-surgical hospitalization of two nights or more between 2009 and 2019.
More than 800,000 of these patients, ages 19 to 87, had sepsis during their hospital stay.
Researchers included two standard diagnosis codes used for sepsis: explicit and implicit. Explicit sepsis means that a physician formally diagnosed the patient. Implicit sepsis is an administrative code in the electronic health record given automatically when a patient has both an infection and organ failure. That is the currently accepted definition of sepsis.
The research team compared the hospitalized patients who had sepsis to more than 1.4 million hospitalized patients who did not develop sepsis but still had heart disease or one of the risk factors.
Patients with implicit sepsis had a twofold increased risk of rehospitalization for heart issues compared to those with explicit sepsis.
The findings were published Feb. 1 in the Journal of the American Heart Association. One limitation is that the study team did not know the severity of patients' sepsis cases.
The U.S. Centers for Disease Control and Prevention has more on sepsis.
SOURCE: American Heart Association, news release, Feb. 1, 2023