Sepsis Increases Risk of Post-Discharge Cardiovascular Events, Death

According to the CDC, each year about 1.7 million adults in the United States develop sepsis.

As one of the leading causes of hospitalization, researchers know that sepsis can prompt a major cardiovascular event including heart failure. But are adult patients who recovered from sepsis at a higher risk of developing a post-discharge cardiovascular event?

In a recent retrospective cohort analysis, researchers determined the answer is a resounding “yes”. Indeed, patients either hospitalized with sepsis or who developed it while hospitalized had a higher risk of rehospitalization for cardiovascular events (43%) compared with those hospitalized without sepsis. When compared with patients who did not have sepsis during hospitalization, those with sepsis were 27% more likely to die and 38% more likely to be rehospitalized for any cause.

“Compared with patients hospitalized without a sepsis diagnosis, patients hospitalized with sepsis had an elevated risk of all examined postdischarge adverse events,” the researchers wrote.

The researchers used a database containing administrative claims data to eventually identify more than 2 million commercial and Medicare Advantage enrollees throughout the United States from 2009-2021. Of these adult patients, the medical claims showed that more than 800,000 patients had sepsis during their hospital stay. They then compared that group with about 1.45 million hospitalized patients who did not develop sepsis but had at least one cardiovascular disease risk factor, including older age, hypertension, hyperlipidemia, type 2 diabetes, chronic kidney disease, obesity, or smoking.

Looking deeper into the data, the researchers also found that heart failure was the most common major cardiovascular event among those who had sepsis. Further, those hospitalized with sepsis had a 51% higher risk of developing heart failure during the 12-year follow-up period.

The authors noted several limitations to their study. For example, the authors were limited in their analysis due to the variability associated with the documentation of diagnosis codes to identify diseases of interest. Additionally, the authors did not have a gold-standard definition for sepsis, which could have impacted the association with the results.

Despite these limitations, the authors are confident that the current study will warrant further examination of the underlying associations between sepsis and the risk of post-discharge cardiovascular events.

“The increased risk for cardiovascular disease after sepsis hospitalization necessitates diligent follow‐up and optimization of guideline‐directed medical therapies in patients with preexisting cardiovascular disease,” the authors concluded. “It is imperative to determine the mechanisms underlying this association and whether standard medical therapies for cardiovascular prevention are efficacious for reducing the risk of cardiovascular events associated with sepsis survivorship in the absence of preexisting cardiovascular disease.”

Want more insight on this research? Check out this Q&A with lead author, Jacob C. Jentzer, MD.

Reference: Jentzer JC, Lawler PR, Van Houten HK, Yao X, Kashani KB, Dunlay SM. Cardiovascular events among survivors of sepsis hospitalization: a retrospective cohort analysis. J Am Heart Assoc. 2023;12(3):e027813. doi:10.1161/JAHA.122.027813.