Infection-Related Hospitalization in Heart Failure With Reduced Ejection Fraction: A Prospective Observational Cohort Study.

Autor:	Drozd M; Leeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Clarendon Way, Leeds, United Kingdom (M.D., E.G., A.M.N.W., T.A.S., A.K., S.S., J.G., M.P., J.L., K.K.W., M.T.K., R.M.C.)., Garland E; Leeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Clarendon Way, Leeds, United Kingdom (M.D., E.G., A.M.N.W., T.A.S., A.K., S.S., J.G., M.P., J.L., K.K.W., M.T.K., R.M.C.)., Walker AMN; Leeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Clarendon Way, Leeds, United Kingdom (M.D., E.G., A.M.N.W., T.A.S., A.K., S.S., J.G., M.P., J.L., K.K.W., M.T.K., R.M.C.)., Slater TA; Leeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Clarendon Way, Leeds, United Kingdom (M.D., E.G., A.M.N.W., T.A.S., A.K., S.S., J.G., M.P., J.L., K.K.W., M.T.K., R.M.C.)., Koshy A; Leeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Clarendon Way, Leeds, United Kingdom (M.D., E.G., A.M.N.W., T.A.S., A.K., S.S., J.G., M.P., J.L., K.K.W., M.T.K., R.M.C.)., Straw S; Leeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Clarendon Way, Leeds, United Kingdom (M.D., E.G., A.M.N.W., T.A.S., A.K., S.S., J.G., M.P., J.L., K.K.W., M.T.K., R.M.C.)., Gierula J; Leeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Clarendon Way, Leeds, United Kingdom (M.D., E.G., A.M.N.W., T.A.S., A.K., S.S., J.G., M.P., J.L., K.K.W., M.T.K., R.M.C.)., Paton M; Leeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Clarendon Way, Leeds, United Kingdom (M.D., E.G., A.M.N.W., T.A.S., A.K., S.S., J.G., M.P., J.L., K.K.W., M.T.K., R.M.C.)., Lowry J; Leeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Clarendon Way, Leeds, United Kingdom (M.D., E.G., A.M.N.W., T.A.S., A.K., S.S., J.G., M.P., J.L., K.K.W., M.T.K., R.M.C.)., Sapsford R; Department of Cardiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Great George Street, Leeds, United Kingdom (R.S.)., Witte KK; Leeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Clarendon Way, Leeds, United Kingdom (M.D., E.G., A.M.N.W., T.A.S., A.K., S.S., J.G., M.P., J.L., K.K.W., M.T.K., R.M.C.)., Kearney MT; Leeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Clarendon Way, Leeds, United Kingdom (M.D., E.G., A.M.N.W., T.A.S., A.K., S.S., J.G., M.P., J.L., K.K.W., M.T.K., R.M.C.)., Cubbon RM; Leeds Institute of Cardiovascular and Metabolic Medicine, The University of Leeds, Clarendon Way, Leeds, United Kingdom (M.D., E.G., A.M.N.W., T.A.S., A.K., S.S., J.G., M.P., J.L., K.K.W., M.T.K., R.M.C.).
Jazyk:	angličtina
Zdroj:	Circulation. Heart failure [Circ Heart Fail] 2020 May; Vol. 13 (5), pp. e006746. Date of Electronic Publication: 2020 May 01.
DOI:	10.1161/CIRCHEARTFAILURE.119.006746
Abstrakt:	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.
Databáze:	MEDLINE
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