Sepsis ‘increases risk of heart failure’ for more than a decade

Sepsis can increase the risk of heart failure and rehospitalisation within 12 years, according to a new study.

After being discharged, those hospitalised for sepsis or who developed it while in hospital had a 38 per cent higher risk of rehospitalisation.

They were also 43 per cent more at risk of returning to hospital for a cardiovascular problem compared to people who didn’t suffer from sepsis.

The risk of developing heart failure after leaving hospital was 51 per cent higher among those who had sepsis while in hospital.

Additionally, those who had sepsis while hospitalised had a 27 per cent higher risk of death after leaving hospital.

Sepsis is a leading cause of hospitalisation and death worldwide. Early warning signs include an extremely high or low temperature, uncontrolled shivering, confusion, blotchy patches on arms or legs and passing little urine.

Each year in the US, about 1.7 million people develop sepsis.

Sepsis is an extreme immune response to an infection in the bloodstream that can spread throughout the whole body and lead to organ failure and possibly death.

According to Sepsis Research: “Sepsis alone accounts for around 50,000 deaths every year within the UK.

“This is more than the total combined number of deaths due to breast, bowel and prostate cancer.

“Five people in the UK die every hour from sepsis, with over 4000 occurring in Scotland annually.”

Author Dr Jacob Jentzer, an assistant professor at the Mayo Clinic in Rochester, Minnesota, said: “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.

“We sought to describe the association between sepsis during hospitalisation and subsequent death and rehospitalization among a large group of adults.”

The team studied a database which revealed how many people in the US survived a non-surgical hospitalisation of two nights or more between 2009 and 2019.

Of these patients, who were between 19 and 87 years-old, they found that more than 800,000 had sepsis during their hospital stay.

They then analysed the link of hospitalisation with sepsis, rehospitalisation and death over a follow-up period from 2009 and 2021.

Researchers compared 808,673 hospitalised patients who had sepsis with almost 1,500,000 hospitalised patients who didn’t have sepsis but had cardiovascular disease or one or more cardiovascular disease risk factors. These could be old age, obesity or type two diabetes.

Researchers characterised sepsis as explicit and implicit.

Explicit sepsis means a doctor formally diagnosed the patient. Implicit sepsis refers to patients that suffered both an infection and organ failure but a doctor didn’t diagnose them with it.

The study found that patients with implicit sepsis were twice as likely to be hospitalised again for cardiovascular events compared to those with explicit sepsis.

Dr Jentzer said: “Our findings indicate that after hospitalisation with sepsis, close follow-up care is important, and it may be valuable to implement cardiovascular prevention therapies with close supervision.

“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.”

The main limitation of the study was that the data didn’t offer the severity of the sepsis.

The team now plan to continue evaluating new data on people who have previously had sepsis during hospitalisation to map out their needs for cardiovascular prevention therapies.

Dr Jentzer said: “It’s an important opportunity to establish what might and might not work in the future for people who have had sepsis.”

The study was published in the Journal of the American Heart Association.