Cardiovascular Events and Hospital Deaths Among Patients With Severe Sepsis

Nirav Patel, Navkaranbir S. Bajaj, Rajkumar Doshi, Ankur Gupta, Rajat Kalra, Amitoj Singh, Lorenzo Berra, Garima Arora, Sumanth D. Prabhu, Pankaj Arora

Research output: Contribution to journalArticle

Abstract

The burden of cardiovascular events among patients hospitalized with severe sepsis and the association of these events with in-hospital mortality is not well known. We examined the incidence of cardiovascular events and their association with in-hospital mortality among patients with severe sepsis. Patients with severe sepsis from the New York State Inpatient Database from 2012 through 2014 were identified using a validated International Classification of Diseases 9th Revision, Clinical Modification code 995.92. The primary outcome was the incidence of cardiovascular events during the hospitalizations, defined as a composite of ischemic, acute heart failure, or arrhythmic events and the secondary outcome was in-hospital mortality. Multivariable logistic regression models were used to compare the risk of in-hospital mortality among severe sepsis patients with and without cardiovascular events. A total of 117,418 patients (mean age, 70.8 years; 50.4% males, 59.5% whites) with severe sepsis occurred during the study period 2012 to 2014. New-onset (incident) cardiovascular event occurred in 13.1%, ischemic events in 4.5%, acute heart failure events in 2.3%, and arrhythmic events in 8.0% of patients, respectively. An estimated 32.9% of patients with severe sepsis died during their hospitalization. Severe sepsis patients with new-onset cardiovascular events were associated with 30% higher odds for in-hospital mortality (odds ratio: 1.30; 95% CI: 1.23 to 1.37, p < 0.001) as compared with patients without cardiovascular events in multivariable adjusted model. In conclusion, among patients with severe sepsis, incident cardiovascular events occur frequently. Further research is required to improve recognition and treatment of new-onset cardiovascular events in patients with severe sepsis.

Original languageEnglish (US)
Pages (from-to)1406-1413
Number of pages8
JournalAmerican Journal of Cardiology
Volume123
Issue number9
DOIs
StatePublished - May 1 2019

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Sepsis
Hospital Mortality
Hospitalization
Heart Failure
Logistic Models
Incidence
International Classification of Diseases
Inpatients
Odds Ratio
Databases
Research

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Cardiovascular Events and Hospital Deaths Among Patients With Severe Sepsis. / Patel, Nirav; Bajaj, Navkaranbir S.; Doshi, Rajkumar; Gupta, Ankur; Kalra, Rajat; Singh, Amitoj; Berra, Lorenzo; Arora, Garima; Prabhu, Sumanth D.; Arora, Pankaj.

In: American Journal of Cardiology, Vol. 123, No. 9, 01.05.2019, p. 1406-1413.

Research output: Contribution to journalArticle

Patel, N, Bajaj, NS, Doshi, R, Gupta, A, Kalra, R, Singh, A, Berra, L, Arora, G, Prabhu, SD & Arora, P 2019, 'Cardiovascular Events and Hospital Deaths Among Patients With Severe Sepsis', American Journal of Cardiology, vol. 123, no. 9, pp. 1406-1413. https://doi.org/10.1016/j.amjcard.2019.01.038
Patel, Nirav ; Bajaj, Navkaranbir S. ; Doshi, Rajkumar ; Gupta, Ankur ; Kalra, Rajat ; Singh, Amitoj ; Berra, Lorenzo ; Arora, Garima ; Prabhu, Sumanth D. ; Arora, Pankaj. / Cardiovascular Events and Hospital Deaths Among Patients With Severe Sepsis. In: American Journal of Cardiology. 2019 ; Vol. 123, No. 9. pp. 1406-1413.
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abstract = "The burden of cardiovascular events among patients hospitalized with severe sepsis and the association of these events with in-hospital mortality is not well known. We examined the incidence of cardiovascular events and their association with in-hospital mortality among patients with severe sepsis. Patients with severe sepsis from the New York State Inpatient Database from 2012 through 2014 were identified using a validated International Classification of Diseases 9th Revision, Clinical Modification code 995.92. The primary outcome was the incidence of cardiovascular events during the hospitalizations, defined as a composite of ischemic, acute heart failure, or arrhythmic events and the secondary outcome was in-hospital mortality. Multivariable logistic regression models were used to compare the risk of in-hospital mortality among severe sepsis patients with and without cardiovascular events. A total of 117,418 patients (mean age, 70.8 years; 50.4{\%} males, 59.5{\%} whites) with severe sepsis occurred during the study period 2012 to 2014. New-onset (incident) cardiovascular event occurred in 13.1{\%}, ischemic events in 4.5{\%}, acute heart failure events in 2.3{\%}, and arrhythmic events in 8.0{\%} of patients, respectively. An estimated 32.9{\%} of patients with severe sepsis died during their hospitalization. Severe sepsis patients with new-onset cardiovascular events were associated with 30{\%} higher odds for in-hospital mortality (odds ratio: 1.30; 95{\%} CI: 1.23 to 1.37, p < 0.001) as compared with patients without cardiovascular events in multivariable adjusted model. In conclusion, among patients with severe sepsis, incident cardiovascular events occur frequently. Further research is required to improve recognition and treatment of new-onset cardiovascular events in patients with severe sepsis.",
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AB - The burden of cardiovascular events among patients hospitalized with severe sepsis and the association of these events with in-hospital mortality is not well known. We examined the incidence of cardiovascular events and their association with in-hospital mortality among patients with severe sepsis. Patients with severe sepsis from the New York State Inpatient Database from 2012 through 2014 were identified using a validated International Classification of Diseases 9th Revision, Clinical Modification code 995.92. The primary outcome was the incidence of cardiovascular events during the hospitalizations, defined as a composite of ischemic, acute heart failure, or arrhythmic events and the secondary outcome was in-hospital mortality. Multivariable logistic regression models were used to compare the risk of in-hospital mortality among severe sepsis patients with and without cardiovascular events. A total of 117,418 patients (mean age, 70.8 years; 50.4% males, 59.5% whites) with severe sepsis occurred during the study period 2012 to 2014. New-onset (incident) cardiovascular event occurred in 13.1%, ischemic events in 4.5%, acute heart failure events in 2.3%, and arrhythmic events in 8.0% of patients, respectively. An estimated 32.9% of patients with severe sepsis died during their hospitalization. Severe sepsis patients with new-onset cardiovascular events were associated with 30% higher odds for in-hospital mortality (odds ratio: 1.30; 95% CI: 1.23 to 1.37, p < 0.001) as compared with patients without cardiovascular events in multivariable adjusted model. In conclusion, among patients with severe sepsis, incident cardiovascular events occur frequently. Further research is required to improve recognition and treatment of new-onset cardiovascular events in patients with severe sepsis.

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