Key result
Subsequent septic shock in patients with sepsis was associated with higher in-hospital mortality (31.2% vs 5.3%) and increased cardiovascular events including acute kidney injury (65.1% vs 32.8%).
Why the study?
Sepsis patients who experience subsequent cardiovascular events face increased mortality, but data regarding these events are limited among patients with septic shock.
Does the development of subsequent septic shock increase the occurrence of in-hospital mortality and cardiovascular events in patients with sepsis?
Observational (n=2,127,137)
Yes
Does the development of subsequent septic shock increase the occurrence of in-hospital mortality and cardiovascular events in patients with sepsis?
The progression from sepsis to septic shock is associated with a markedly increased risk of in-hospital mortality and adverse cardiovascular events.
Septic shock progression in sepsis signals sharply elevated mortality and CV risk; leaves open whether early interventions improve outcomes in prospective studies.
Introduction: Mortality estimates from sepsis and septic shock ranged from 18% to 35% and 40% to 60%, respectively, prior to 2014. Sepsis patients who experience subsequent cardiovascular events have increased mortality; however, data are limited among septic shock patients. This study reports in-hospital mortality, incident cardiovascular events, and cardiovascular procedures among sepsis patients with and without subsequent septic shock. Methods: Patients with a primary diagnosis of sepsis with and without a secondary diagnosis of septic shock were identified from the 2016 and 2017 National Readmissions Database. These patients were then evaluated for the occurrence of cardiovascular events and procedures. Results: A total of 2,127,137 patients were included in the study, with a mean age of 66 years. Twenty percent of patients (n = 420,135) developed subsequent septic shock. In-hospital mortality among patients with a primary diagnosis of sepsis was 5.3%, and it was 31.2% for those with subsequent septic shock. Notable cardiovascular events occurring among sepsis patients with and without subsequent septic shock, respectively, included: acute kidney injury (65.1% vs. 32.8%, P < .0001), acute systolic heart failure (9.8% vs. 5.1%, P < .0001), NSTEMI (8.8% vs. 3.2%, P < .0001), and ischemic stroke (2.3% vs. 0.9%, P < .0001). Similarly, the most common cardiovascular procedures between the two groups were: percutaneous coronary intervention (0.37% vs. 0.20%, P < .0001), intra-aortic balloon pump (0.19% vs. 0.02%, P < .0001), and extracorporeal membrane oxygenation (0.18% vs. 0.01%, P < .0001). Conclusions: Sepsis with subsequent septic shock is associated with an increased frequency of in-hospital cardiovascular events and procedures.
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Falk et al. (2022) conducted an observational in Sepsis (n=2,127,137). Subsequent septic shock vs. Sepsis without subsequent septic shock was evaluated on In-hospital mortality. Subsequent septic shock in patients with sepsis was associated with higher in-hospital mortality (31.2% vs 5.3%) and increased cardiovascular events including acute kidney injury (65.1% vs 32.8%).
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