Abstract 17089: In Hospital Cardiovascular Outcomes of Patients With End Stage Renal Disease and Septic Shock a Propensity Matched Analysis

Abstract

Background: Sepsis affects approximately 1.7 million adults in the US every year, and progression to septic shock (SS) leads to an increase in cardiovascular disease (CVD) and a 26% increase in mortality. Patients with end stage renal disease (ESRD) on dialysis are at an increased risk of developing SS and CVD. The increase in mortality with SS is well established in the literature, however, there is limited data determining the impact of ESRD on SS. This study aims to identify the impact of ESRD on in-hospital mortality and CVD outcomes among patients with SS. Methods: The 2020 National Readmissions Database was analyzed. Patients with SS and ESRD were identified using relevant ICD-10 codes. Nearest propensity matching was conducted using a 1:1 ratio for several demographic, social and clinical variables. Subsequently, in-hospital outcomes were compared between patients with and without ESRD using t-test and chi-squared test as appropriate. Results: A total of 822,321 patients were included in this study, with a mean age of 65 years. Majority of patients in this study with and without ESRD respectively were male (54.39% and 50.83%, p <0.001). In- hospital mortality for patients with SS, with and without ESRD, were 38.68% and 30.01%, respectively. Among patients with SS, mortality with and without ESRD was 38.36% and 30.01% (p < 0.001) respectively. Other significant cardiovascular events among patients with and without ESRD, respectively were ischemic stroke (3.82% vs. 3.28%, p <0.001), atrial fibrillation (11.85% vs. 10.2%, p <0.001), Endocarditis (4.06% vs. 2.24%, p <0.001), and acute diastolic heart failure (10.17% vs. 9.41%, p =0.001). Conclusions: SS in patients with ESRD is associated with an increased frequency of in-hospital mortality and worse cardiovascular outcomes when compared to patients without ESRD. Further research is needed to help establish and identify the causative factors in determining the association between SS and ESRD.