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Sepsis hospitalization and risk of subsequent cardiovascular events in adults: a population-based matched cohort study
- Source :
- Intensive Care Medicine. April, 2022, Vol. 48 Issue 4, p448, 10 p.
- Publication Year :
- 2022
-
Abstract
- Purpose To determine whether surviving a first sepsis hospitalization is associated with long-term cardiovascular events. Methods Population-based matched cohort study conducted in Ontario, Canada (2008-2017). Adult survivors (older than 18 years) of a first sepsis hospitalization were matched to adult survivors of a non-sepsis hospitalization using hard-matching and propensity score methods. Patients with pre-existing cardiovascular disease were excluded. The primary composite outcome was myocardial infarction, stroke, or cardiovascular death up to 5 years of follow-up. Secondary outcomes included venous thromboembolism and all-cause death. Cox proportional hazards models with robust standard errors were used to estimate the association of sepsis with all outcomes of interest; hazard ratios (HR) and 95% confidence intervals (CI) were calculated. Sensitivity analyses included Fine and Gray models to account for the competing risk of all-cause death and probabilistic bias analyses. Results 254,241 adult sepsis survivors were matched to adult survivors of non-sepsis hospitalization episodes. Sepsis survivors experienced an increased hazard of major cardiovascular events compared to non-sepsis survivors (HR 1.30; 95% CI 1.27-1.32), which was more pronounced in younger patients (HR 1.66; 95% CI 1.36-2.02 for patients aged 40 or younger; HR 1.21; 95% CI 1.18-1.24 for patients older than 80 years). Sepsis survivors also faced an increased hazard of venous thromboembolism (HR 1.61; 95% CI 1.55-1.67) and all-cause death (HR 1.26; 95% CI 1.25-1.27). Sensitivity analyses yielded consistent results. Conclusions Adult sepsis survivors experience an increased hazard of major cardiovascular events compared to survivors of a non-sepsis hospitalization.<br />Author(s): Federico Angriman [sup.1] [sup.2] [sup.3], Laura C. Rosella [sup.4] [sup.5] [sup.8] [sup.9], Patrick R. Lawler [sup.2] [sup.6], Dennis T. Ko [sup.5] [sup.7], Hannah Wunsch [sup.1] [sup.2] [sup.3] [sup.5], Damon [...]
- Subjects :
- Ontario. Ministry of Health and Long-Term Care
Heart attack -- Complications and side effects -- Risk factors
Thromboembolism -- Risk factors -- Complications and side effects
Infection -- Risk factors -- Complications and side effects
Adults
Cardiovascular diseases -- Risk factors -- Complications and side effects
Health care industry
Subjects
Details
- Language :
- English
- ISSN :
- 03424642
- Volume :
- 48
- Issue :
- 4
- Database :
- Gale General OneFile
- Journal :
- Intensive Care Medicine
- Publication Type :
- Academic Journal
- Accession number :
- edsgcl.723892694
- Full Text :
- https://doi.org/10.1007/s00134-022-06634-z