Predictors of Poor Outcomes in Patients with Heart Failure and Sepsis

Abstract

BackgroundSepsis management in patients with heart failure (HF) is complex and challenging. Currently, there is limited data about the predictors of poor outcomes in patient with HF that are hospitalized with sepsis.MethodsThis is a retrospective cohort study of patients with a diagnosis of heart failure and sepsis that were hospitalized between January 2015 to December 2018. The primary outcome was overall and in-hospital mortality. Secondary outcomes predictors of poor outcomes in patients with sepsis and ADHF.ResultsThis cohort of 1110 patients included 443/1110 (56%) men with a mean age of 75±14 (see Table I for baseline characteristics). A total of 320/1110 patients with heart failure and sepsis experienced death during the initial hospitalization. Markers of clinically relevant outcomes are listed in Table I. A logistic regression was performed for all relevant variables and demonstrated that acute kidney injury, lactic acidosis, elevated BUN, and low systolic blood pressure were strong indicators of poor outcomes in patients with heart failure and sepsis (p-value <0.0001 for each, respectively).ConclusionsPredictors of poor outcome among patients with sepsis and HF are crucial. Our model showed that the presence of acute kidney injury during hospitalization, low blood pressure, elevated BUN and the need for vasopressors are predicting mortality in this special population. Further studies are recommended to test this hypothesis. Sepsis management in patients with heart failure (HF) is complex and challenging. Currently, there is limited data about the predictors of poor outcomes in patient with HF that are hospitalized with sepsis. This is a retrospective cohort study of patients with a diagnosis of heart failure and sepsis that were hospitalized between January 2015 to December 2018. The primary outcome was overall and in-hospital mortality. Secondary outcomes predictors of poor outcomes in patients with sepsis and ADHF. This cohort of 1110 patients included 443/1110 (56%) men with a mean age of 75±14 (see Table I for baseline characteristics). A total of 320/1110 patients with heart failure and sepsis experienced death during the initial hospitalization. Markers of clinically relevant outcomes are listed in Table I. A logistic regression was performed for all relevant variables and demonstrated that acute kidney injury, lactic acidosis, elevated BUN, and low systolic blood pressure were strong indicators of poor outcomes in patients with heart failure and sepsis (p-value <0.0001 for each, respectively). Predictors of poor outcome among patients with sepsis and HF are crucial. Our model showed that the presence of acute kidney injury during hospitalization, low blood pressure, elevated BUN and the need for vasopressors are predicting mortality in this special population. Further studies are recommended to test this hypothesis.