Molinsky Rebecca L, Lutsey Pamela L, Walker Rob F, Wang Wendy, Yuzefpolskaya Melana, Giorgio Katherine, Vock David M, MacLehose Richard, Colombo Paolo C, Demmer Ryan T
Division of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN USA.
Division of Cardiology, Department of Medicine Columbia University Irving Medical Center New York NY USA.
J Am Heart Assoc. 2025 Jun 3;14(11):e039123. doi: 10.1161/JAHA.123.039123. Epub 2025 May 23.
Heart failure (HF) is a growing public health burden. Systemic inflammation is commonly observed in patients with HF and believed to be related to disease pathogenesis. Infection is a potential acute trigger of chronic inflammation. Our objective was to examine the relationship between infection-related hospitalization (IRH) and HF.
We studied beneficiaries with at least 15 months of continuous enrollment in the US-based MarketScan databases during 2013 to 2019. We included n=152 008 patients with an inpatient or outpatient HF () code in the primary position. Among patients with HF, IRH was identified using select codes. We used a case-crossover design to compare the frequency of IRH occurring within 3 months of the index HF event (case period) versus the frequency of IRH occurring 12 to 15 months before the index HF event (control period). Logistic models regressed the log-odds of having an IRH during the case versus control periods; odds ratios (ORs; 95% CIs) are presented. Among 152 008 beneficiaries, 53% were male with a mean±SD age of 56(±11) years. The odds of having an IRH during the case (versus control) period was elevated for both the 3-month case period (OR, 4.39 [95% CI, 4.18-4.60]), and 1-month case period (OR, 7.39 [95% CI, 6.88-7.94]), after adjusting for the total number of hospitalizations. This relationship persisted across different types of infections.
IRH was associated with incident HF after both 1 and 3 months and may represent a modifiable risk factor for HF.
心力衰竭（HF）是日益加重的公共卫生负担。全身炎症在HF患者中普遍存在，且被认为与疾病发病机制有关。感染是慢性炎症的一个潜在急性触发因素。我们的目的是研究感染相关住院（IRH）与HF之间的关系。
我们研究了2013年至2019年期间在美国MarketScan数据库中连续参保至少15个月的受益人群。我们纳入了n = 152008例主要诊断为住院或门诊HF（）代码的患者。在HF患者中，通过特定代码识别IRH。我们采用病例交叉设计，比较索引HF事件发生后3个月内（病例期）IRH发生频率与索引HF事件发生前12至15个月（对照期）IRH发生频率。逻辑模型对病例期与对照期发生IRH的对数优势进行回归分析；呈现优势比（ORs；95%置信区间）。在152008名受益人中，53%为男性，平均年龄±标准差为56（±11）岁。在调整住院总数后，3个月病例期（OR，4.39 [95% CI，4.18 - 4.60]）和1个月病例期（OR，7.39 [95% CI，6.88 - 7.94]）的病例期（与对照期相比）发生IRH的几率均升高。这种关系在不同类型的感染中均持续存在。
IRH在1个月和3个月后均与新发HF相关，可能是HF的一个可改变的危险因素。
