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Sepsis confers stroke, MI risk up to 4 weeks after hospital discharge
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Compared with matched participants from the general population, patients with hospital-acquired sepsis were at elevated risk for stroke and MI up to 4 weeks after discharge, researchers reported.
The researchers conducted a retrospective cohort study of patients with sepsis from the National Health Insurance Research Database in Taiwan to determine temporal change and susceptible periods for CV complications after hospital discharge. They matched 42,316 patients with sepsis with a general population and hospital control cohort.
The primary outcome was first occurrence of MI or stroke requiring hospital admission up to 180 days after index discharge. The researchers plotted weekly risk for stroke and MI against time and conducted an analysis to determine the susceptible period.
At 180 days, 831 patients with sepsis developed stroke and 184 developed MI, according to the researchers.
Compared with population controls, the sepsis cohort had its highest risk for MI or stroke in the first week after discharge (HR = 4.78; 95% CI, 3.19-7.17; risk difference, 0.0028; 95% CI, 0.0021-0.0034). After that, risk decreased until day 28 (HR = 2.38; 95% CI, 1.94-2.92; risk difference, 0.0045; 95% CI, 0.0035-0.0056) and stabilized after 4 weeks, the researchers wrote.
In a repeated analysis comparing the sepsis cohort with hospital controls, risk for MI or stroke in the sepsis cohort was attenuated but still significant up to day 36 after index discharge (HR = 1.32; 95% CI, 1.15-1.52; risk difference, 0.0026; 95% CI, 0.0013-0.0039).
The elevated risk for MI or stroke in patients with sepsis was more pronounced in younger patients (P for interaction = .0004), according to the researchers.
The findings confirm a similar study in a Danish population, the researchers wrote.
“Based on our study (Han Chinese) and the study in Denmark (European) that reported similar findings for two different ethnic groups, it is likely that these results are generalizable to different populations,” Chih-Cheng Lai, MD, from the department of intensive care medicine at Chi Mei Medical Center, Liouying, Taiwan, and colleagues wrote. – by Erik Swain
Disclosures: The authors report no relevant financial disclosures.
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