BACKGROUND: Hospitalization is a common adverse event in people with heart failure and reduced ejection fraction, yet is often not primarily due to decompensated heart failure (HF). We investigated the long-term prognosis following infection-related hospitalization. METHODS: We conducted a prospective observational cohort study of 711 people with heart failure and reduced ejection fraction recruited from 4 specialist HF clinics in the United Kingdom. All hospitalization episodes (n=1568) were recorded and categorized as primarily due to decompensated HF, other cardiovascular disease, infection-related, or other noncardiovascular disease. Survival was determined after the first hospitalization. RESULTS: During 2900 patient-years of follow-up, there were a total of 14 686 hospital days. At least one hospitalization occurred in 467 people (66%); 25% of first hospitalizations were primarily due to infection and these were not associated with typical signs including tachycardia and pyrexia. Compared with other categories of hospitalization, infection-related was associated with older age, lower serum albumin, higher blood neutrophil counts, and greater prevalence of chronic obstructive pulmonary disease at recruitment. Median survival after first infection-related hospitalization was 18.6 months, comparable to that after first decompensated HF hospitalization, even after age-sex adjustment. The burden of all-cause rehospitalization was comparable irrespective of the category of first hospitalization, but infection more commonly caused re-hospitalization after index infection hospitalization. CONCLUSIONS: Infection is a common driver of hospitalization in heart failure and reduced ejection fraction and often presents without classical signs. It is associated with high mortality rates, comparable to decompensated HF, and a major burden of rehospitalization caused by recurrent episodes of infection.
BACKGROUND: Hospitalization is a common adverse event in people with heart failure and reduced ejection fraction, yet is often not primarily due to decompensated heart failure (HF). We investigated the long-term prognosis following infection-related hospitalization. METHODS: We conducted a prospective observational cohort study of 711 people with heart failure and reduced ejection fraction recruited from 4 specialist HF clinics in the United Kingdom. All hospitalization episodes (n=1568) were recorded and categorized as primarily due to decompensated HF, other cardiovascular disease, infection-related, or other noncardiovascular disease. Survival was determined after the first hospitalization. RESULTS: During 2900 patient-years of follow-up, there were a total of 14 686 hospital days. At least one hospitalization occurred in 467 people (66%); 25% of first hospitalizations were primarily due to infection and these were not associated with typical signs including tachycardia and pyrexia. Compared with other categories of hospitalization, infection-related was associated with older age, lower serum albumin, higher blood neutrophil counts, and greater prevalence of chronic obstructive pulmonary disease at recruitment. Median survival after first infection-related hospitalization was 18.6 months, comparable to that after first decompensated HF hospitalization, even after age-sex adjustment. The burden of all-cause rehospitalization was comparable irrespective of the category of first hospitalization, but infection more commonly caused re-hospitalization after index infection hospitalization. CONCLUSIONS: Infection is a common driver of hospitalization in heart failure and reduced ejection fraction and often presents without classical signs. It is associated with high mortality rates, comparable to decompensated HF, and a major burden of rehospitalization caused by recurrent episodes of infection.
Authors: Melana Yuzefpolskaya; Heidi S Lumish; Azka Javaid; Barbara Cagliostro; Giulio M Mondellini; Bruno Bohn; Austin Sweat; Duygu Onat; Lorenzo Braghieri; Koji Takeda; Yoshifumi Naka; Gabriel T Sayer; Nir Uriel; Justin G Aaron; Emmanuel Montassier; Ryan T Demmer; Paolo C Colombo Journal: Eur J Heart Fail Date: 2021-05-31 Impact factor: 17.349
Authors: Anam Malik; Ellis Garland; Michael Drozd; Victoria Palin; Marilena Giannoudi; Sam Straw; Nick Jex; Andrew Mn Walker; John Gierula; Maria Paton; Klaus K Witte; Mark T Kearney; Eylem Levelt; Richard M Cubbon Journal: Diab Vasc Dis Res Date: 2022 Jan-Feb Impact factor: 3.541
Authors: Michael Drozd; Mar Pujades-Rodriguez; Patrick J Lillie; Sam Straw; Ann W Morgan; Mark T Kearney; Klaus K Witte; Richard M Cubbon Journal: Lancet Infect Dis Date: 2021-03-01 Impact factor: 25.071
Authors: Giuseppe De Matteis; Marcello Covino; Maria Livia Burzo; Davide Antonio Della Polla; Francesco Franceschi; Alexandre Mebazaa; Giovanni Gambassi Journal: J Clin Med Date: 2022-01-15 Impact factor: 4.241