Department of Internal Medicine, Hennepin Healthcare, Minneapolis, MN, USA.
Department of Internal Medicine, Hennepin Healthcare, Minneapolis, MN, USA.
Curr Probl Cardiol. 2024 Sep;49(9):102696. doi: 10.1016/j.cpcardiol.2024.102696. Epub 2024 Jun 7.
BACKGROUND: Patients with heart failure with reduced ejection fraction (HFrEF) are at increased risk for sepsis/septic shock. METHOD: A retrospective study was conducted using the Nationwide Readmission Database (2016-2020). Adult patients admitted with sepsis or septic shock were identified and stratified based on the presence of underlying HFrEF. Multivariable logistic regression assessed the association between HFrEF and in-hospital mortality, 90-day readmission, and other complications. RESULTS: Among 7,326,930 sepsis/septic shock admissions, 6.2 % had HFrEF. HFrEF patients had higher in-hospital mortality (17 % vs. 9.6 %, p < 0.01) and 90-day readmission rates (30.2 % vs. 22.5 %, p < 0.01) compared to those without HFrEF. These differences persisted after adjustment with increased risk of in-hospital mortality (aOR 1.40, 95 %CI 1.38-1.42) and 90-day readmission (aOR 1.15, 95 %CI 1.13-1.16). CONCLUSION: HFrEF patients admitted with sepsis/septic shock have significantly higher rates of in-hospital mortality, complications, and 90-day readmissions compared to those without HFrEF.
背景：射血分数降低的心力衰竭（HFrEF）患者发生脓毒症/脓毒性休克的风险增加。
方法：本研究采用回顾性研究方法，使用全国再入院数据库（2016-2020 年）。确定并根据是否存在潜在的 HFrEF 将因败血症或脓毒性休克入院的成年患者分层。多变量逻辑回归评估了 HFrEF 与住院内死亡率、90 天再入院率和其他并发症之间的关系。
结果：在 7326930 例败血症/脓毒性休克入院患者中，有 6.2%的患者存在 HFrEF。与无 HFrEF 的患者相比，HFrEF 患者的住院内死亡率（17% vs. 9.6%，p < 0.01）和 90 天再入院率（30.2% vs. 22.5%，p < 0.01）更高。调整后这些差异仍然存在，住院内死亡率的风险增加（调整后优势比[aOR]1.40，95%CI 1.38-1.42）和 90 天再入院率的风险增加（aOR 1.15，95%CI 1.13-1.16）。
结论：与无 HFrEF 的患者相比，因败血症/脓毒性休克入院的 HFrEF 患者的住院内死亡率、并发症发生率和 90 天再入院率明显更高。
JAMA Otolaryngol Head Neck Surg. 2016-12-1
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