Sepsis, Septic Shock, and Differences in Cardiovascular Event Occurrence

Abstract

Introduction: Mortality estimates from sepsis and septic shock ranged from 18% to 35% and 40% to 60%, respectively, prior to 2014. Sepsis patients who experience subsequent cardiovascular events have increased mortality; however, data are limited among septic shock patients. This study reports in-hospital mortality, incident cardiovascular events, and cardiovascular procedures among sepsis patients with and without subsequent septic shock. Methods: Patients with a primary diagnosis of sepsis with and without a secondary diagnosis of septic shock were identified from the 2016 and 2017 National Readmissions Database. These patients were then evaluated for the occurrence of cardiovascular events and procedures. Results: A total of 2,127,137 patients were included in the study, with a mean age of 66 years. Twenty percent of patients (n = 420,135) developed subsequent septic shock. In-hospital mortality among patients with a primary diagnosis of sepsis was 5.3%, and it was 31.2% for those with subsequent septic shock. Notable cardiovascular events occurring among sepsis patients with and without subsequent septic shock, respectively, included: acute kidney injury (65.1% vs. 32.8%, P < .0001), acute systolic heart failure (9.8% vs. 5.1%, P < .0001), NSTEMI (8.8% vs. 3.2%, P < .0001), and ischemic stroke (2.3% vs. 0.9%, P < .0001). Similarly, the most common cardiovascular procedures between the two groups were: percutaneous coronary intervention (0.37% vs. 0.20%, P < .0001), intra-aortic balloon pump (0.19% vs. 0.02%, P < .0001), and extracorporeal membrane oxygenation (0.18% vs. 0.01%, P < .0001). Conclusions: Sepsis with subsequent septic shock is associated with an increased frequency of in-hospital cardiovascular events and procedures.

Fibroblast growth factor 23 during septic shock and myocardial injury in ICU patients

“…However, although the measured cardiac output increased and the stroke volume was normal, the myocardial dysfunction in patients with septic shock was still significant [ 17 ]. Importantly, 70%–90% of the mortality of patients with sepsis is significantly related to cardiovascular dysfunction, while the mortality of patients with sepsis without cardiovascular damage is about 20% [ 18 ]. Inflammation may affect cardiac compliance and function during the course of disease [ 19 ].…”

The Value of Serum Procalcitonin, Thromboelastography Combined with Platelet Count in Predicting the Short-Term Progression of Septic Shock in the Intensive Care Unit

“…Hospital mortality rates of septic shock are as high as 40% −60%, which are the leading cause of death in ICU patients. 1 , 2 Although the diagnosis and management of septic shock have been greatly improved, the prognosis is poor and the development of septic shock is rapid. Thus, early prediction of short-term progression and timely adjustment of treatment plans are of great significance for improving treatment effectiveness and prognosis.…”

CD3D and CD247 are the molecular targets of septic shock

“…[2] Mortality increases with the degree of multiorgan failure. [3] The pathogen may be any bacterium, fungus, virus, or parasite. Pathogen infection causes activation of the immune system, releasing a large number of inflammatory factors and mediators, leading to systemic inflammatory response syndrome and multiple organ dysfunction.…”