© ISM/SPL model used for illustrative purposes only
March 2023
Patients hospitalised with sepsis at increased risk of future death and rehospitalisation
By Rebecca Jenkins
Adults discharged after a hospital stay involving sepsis have an increased risk of death in addition to cardiovascular (CV) and non-CV rehospitalisation, research suggests.
The retrospective cohort analysis study included data from 2.25 million US adults with pre-existing CV disease or a CV risk factor who had survived a nonsurgical hospital stay of two nights or more between 2009 and 2019.
Researchers identified 808,673 people who had sepsis during their hospitalisation and compared their outcomes against 1,449,821 hospitalised patients who did not develop sepsis.
The sepsis group had a 27% higher risk of death after hospital discharge compared with the group without sepsis over up to 12 years of follow up.
They also had 38% higher risk of rehospitalisation for all causes and a 43% higher risk of rehospitalisation for CV causes, according to the study published in the Journal of the American Heart Association.
‘Hospital survivors with sepsis were at higher risk of all major cardiovascular events throughout the duration of follow-up, including both atherosclerotic and non-atherosclerotic cardiovascular events, with heart failure hospitalization being the most common cardiovascular event and the cardiovascular event associated with the greatest attributable hazard from sepsis during hospitalization,’ the study authors wrote.
‘The excess risk of cardiovascular events in sepsis survivors is substantial enough in magnitude that sepsis should be considered a non-traditional risk factor for cardiovascular events, and further research is needed to determine how best to mitigate this risk in this vulnerable population.’
Professor Simon Finfer AO, Professorial Fellow at The George Institute for Global Health and Adjunct Professor at UNSW Sydney, said the research confirmed other smaller studies suggesting an increased risk of CV events in patients discharged from hospital after sepsis.
Professor Finfer, who is also Director of Sepsis Australia, said unfortunately there remained ‘widespread ignorance’ about the adverse consequences facing sepsis survivors, including increased risk of CV disease.
‘While there is now greater recognition that patients who have survived sepsis have significant long-term physical, cognitive and psychological morbidity, such recognition is still limited to those in the healthcare system with particular interest in sepsis,’ he told Medicine Today.
Professor Finfer said structured, co-ordinated and holistic care was vital for sepsis survivors, an approach emphasised in the Sepsis Clinical Care Standard recently developed by the Australian Commission for Safety and Quality in Health Care and The George Institute for Global Health.
‘The standard states that a patient who has survived sepsis should receive individualised follow-up care to optimise functional outcomes, minimise recurrence, reduce rehospitalisation and manage the ongoing health effects of sepsis,’ he said.