Sepsis during hospitalization was associated with an elevated risk of cardiovascular hospitalization among survivors (adjusted HR 1.43; 95% CI 1.41-1.44; P<0.001).
Cohort (n=2,258,464)
Yes
Does sepsis during hospitalization increase the risk of subsequent death and cardiovascular rehospitalization among survivors of nonsurgical hospitalization?
Survivors of sepsis hospitalization have a significantly elevated risk of subsequent cardiovascular events, particularly heart failure hospitalization, suggesting sepsis is an important cardiovascular risk factor.
Effect estimate: HR 1.43 (95% CI 1.41-1.44)
p-value: p=<0.001
Background Sepsis is associated with an elevated risk of late cardiovascular events among hospital survivors. Methods and Results We included OptumLabs Data Warehouse patients from 2009 to 2019 who survived a medical/nonsurgical hospitalization lasting at least 2 nights. The association between sepsis during hospitalization, based on explicit and implicit discharge International Classification of Diseases, Ninth Revision ( ICD‐9 )/ Tenth Revision ( ICD‐10 ) diagnosis codes, with subsequent death and rehospitalization was analyzed using Kaplan–Meier survival analysis and multivariable Cox proportional‐hazards models. The study population included 2 258 464 survivors of nonsurgical hospitalization (5 396 051 total patient‐years of follow‐up). A total of 808 673 (35.8%) patients had a sepsis hospitalization, including implicit sepsis only in 448 644, explicit sepsis only in 124 841, and both in 235 188. Patients with sepsis during hospitalization had an elevated risk of all‐cause mortality (adjusted hazard ratio HR, 1.27 95% CI, 1.25–1.28; P <0.001), all‐cause rehospitalization (adjusted HR, 1.38 95% CI, 1.37–1.39; P <0.001), and cardiovascular hospitalization (adjusted HR, 1.43 95% CI, 1.41–1.44; P <0.001), especially heart failure hospitalization (adjusted HR, 1.51 95% CI, 1.49–1.53). Patients with implicit sepsis had higher risk than those with explicit sepsis. A sensitivity analysis using the first hospitalization yielded concordant results for cardiovascular hospitalization (adjusted HR, 1.78 95% CI, 1.76–1.78; P <0.001), as did a propensity‐weighted analysis (adjusted HR, 1.52 95% CI, 1.50–1.54; P <0.001). Conclusions Survivors of sepsis hospitalization are at elevated risk of early and late post‐discharge death as well as cardiovascular and non‐cardiovascular rehospitalization. This hazard spans the spectrum of cardiovascular events and may suggest that sepsis is an important cardiovascular risk factor.
Jentzer et al. (Wed,) conducted a cohort in Sepsis (n=2,258,464). Sepsis during hospitalization vs. Hospitalization without sepsis was evaluated on Cardiovascular hospitalization (HR 1.43, 95% CI 1.41-1.44, p=<0.001). Sepsis during hospitalization was associated with an elevated risk of cardiovascular hospitalization among survivors (adjusted HR 1.43; 95% CI 1.41-1.44; P<0.001).