Newly Diagnosed Infection After Admission for Acute Heart Failure: From the KCHF Registry
Background No studies have explored the association between newly diagnosed infections after admission and clinical outcomes in patients with acute heart failure. We aimed to explore the factors associated with newly diagnosed infection after admission for acute heart failure, and its association wi...
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2021
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oai:doaj.org-article:3349956935b1400fa5e5f5d233e3e3372021-11-16T10:22:43ZNewly Diagnosed Infection After Admission for Acute Heart Failure: From the KCHF Registry10.1161/JAHA.121.0232562047-9980https://doaj.org/article/3349956935b1400fa5e5f5d233e3e3372021-11-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.121.023256https://doaj.org/toc/2047-9980Background No studies have explored the association between newly diagnosed infections after admission and clinical outcomes in patients with acute heart failure. We aimed to explore the factors associated with newly diagnosed infection after admission for acute heart failure, and its association with in‐hospital and post‐discharge clinical outcomes. Methods and Results Among 4056 patients enrolled in the Kyoto Congestive Heart Failure registry, 2399 patients without any obvious infectious disease upon admission were analyzed. The major in‐hospital and post‐discharge outcome measures were all‐cause deaths. There were 215 patients (9.0%) with newly diagnosed infections during hospitalization, and 2184 patients (91.0%) without infection during hospitalization. The factors independently associated with a newly diagnosed infection were age ≥80 years, acute coronary syndrome, non‐ambulatory status, hyponatremia, anemia, intubation, and patients who were not on loop diuretics as outpatients. The newly diagnosed infection group was associated with a higher incidence of in‐hospital mortality (16.3% and 3.2%, P<0.001) and excess adjusted risk of in‐hospital mortality (odds ratio, 6.07 [95% CI, 3.61–10.19], P<0.001) compared with the non‐infection group. The newly diagnosed infection group was also associated with a higher 1‐year incidence of post‐discharge mortality (19.3% in the newly diagnosed infection group and 13.6% in the non‐infection group, P<0.001) and excess adjusted risk of post‐discharge mortality (hazard ratio, 1.49 [95% CI, 1.08–2.07], P=0.02) compared with the non‐infection group. Conclusions Elderly patients with multiple comorbidities were associated with the development of newly diagnosed infections after admission for acute heart failure. Newly diagnosed infections after admission were associated with higher in‐hospital and post‐discharge mortality in patients with acute heart failure. Registration URL: https://clinicaltrials.gov; Unique identifier: NCT02334891.Yuta SekoTakao KatoTakeshi MorimotoHidenori YakuYasutaka InuzukaYodo TamakiNeiko OzasaMasayuki ShibaErika YamamotoYusuke YoshikawaYugo YamashitaTakeshi KitaiRyoji TaniguchiMoritake IguchiKazuya NagaoToshikazu JinnaiAkihiro KomasaRyusuke NishikawaYuichi KawaseTakashi MorinagaMamoru ToyofukuYutaka FurukawaKenji AndoKazushige KadotaYukihito SatoKoichiro KuwaharaTakeshi KimuraWileyarticleacute heart failureheart failureinfectionsmortalityDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 22 (2021) |
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DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
acute heart failure heart failure infections mortality Diseases of the circulatory (Cardiovascular) system RC666-701 |
| spellingShingle |
acute heart failure heart failure infections mortality Diseases of the circulatory (Cardiovascular) system RC666-701 Yuta Seko Takao Kato Takeshi Morimoto Hidenori Yaku Yasutaka Inuzuka Yodo Tamaki Neiko Ozasa Masayuki Shiba Erika Yamamoto Yusuke Yoshikawa Yugo Yamashita Takeshi Kitai Ryoji Taniguchi Moritake Iguchi Kazuya Nagao Toshikazu Jinnai Akihiro Komasa Ryusuke Nishikawa Yuichi Kawase Takashi Morinaga Mamoru Toyofuku Yutaka Furukawa Kenji Ando Kazushige Kadota Yukihito Sato Koichiro Kuwahara Takeshi Kimura Newly Diagnosed Infection After Admission for Acute Heart Failure: From the KCHF Registry |
| description |
Background No studies have explored the association between newly diagnosed infections after admission and clinical outcomes in patients with acute heart failure. We aimed to explore the factors associated with newly diagnosed infection after admission for acute heart failure, and its association with in‐hospital and post‐discharge clinical outcomes. Methods and Results Among 4056 patients enrolled in the Kyoto Congestive Heart Failure registry, 2399 patients without any obvious infectious disease upon admission were analyzed. The major in‐hospital and post‐discharge outcome measures were all‐cause deaths. There were 215 patients (9.0%) with newly diagnosed infections during hospitalization, and 2184 patients (91.0%) without infection during hospitalization. The factors independently associated with a newly diagnosed infection were age ≥80 years, acute coronary syndrome, non‐ambulatory status, hyponatremia, anemia, intubation, and patients who were not on loop diuretics as outpatients. The newly diagnosed infection group was associated with a higher incidence of in‐hospital mortality (16.3% and 3.2%, P<0.001) and excess adjusted risk of in‐hospital mortality (odds ratio, 6.07 [95% CI, 3.61–10.19], P<0.001) compared with the non‐infection group. The newly diagnosed infection group was also associated with a higher 1‐year incidence of post‐discharge mortality (19.3% in the newly diagnosed infection group and 13.6% in the non‐infection group, P<0.001) and excess adjusted risk of post‐discharge mortality (hazard ratio, 1.49 [95% CI, 1.08–2.07], P=0.02) compared with the non‐infection group. Conclusions Elderly patients with multiple comorbidities were associated with the development of newly diagnosed infections after admission for acute heart failure. Newly diagnosed infections after admission were associated with higher in‐hospital and post‐discharge mortality in patients with acute heart failure. Registration URL: https://clinicaltrials.gov; Unique identifier: NCT02334891. |
| format |
article |
| author |
Yuta Seko Takao Kato Takeshi Morimoto Hidenori Yaku Yasutaka Inuzuka Yodo Tamaki Neiko Ozasa Masayuki Shiba Erika Yamamoto Yusuke Yoshikawa Yugo Yamashita Takeshi Kitai Ryoji Taniguchi Moritake Iguchi Kazuya Nagao Toshikazu Jinnai Akihiro Komasa Ryusuke Nishikawa Yuichi Kawase Takashi Morinaga Mamoru Toyofuku Yutaka Furukawa Kenji Ando Kazushige Kadota Yukihito Sato Koichiro Kuwahara Takeshi Kimura |
| author_facet |
Yuta Seko Takao Kato Takeshi Morimoto Hidenori Yaku Yasutaka Inuzuka Yodo Tamaki Neiko Ozasa Masayuki Shiba Erika Yamamoto Yusuke Yoshikawa Yugo Yamashita Takeshi Kitai Ryoji Taniguchi Moritake Iguchi Kazuya Nagao Toshikazu Jinnai Akihiro Komasa Ryusuke Nishikawa Yuichi Kawase Takashi Morinaga Mamoru Toyofuku Yutaka Furukawa Kenji Ando Kazushige Kadota Yukihito Sato Koichiro Kuwahara Takeshi Kimura |
| author_sort |
Yuta Seko |
| title |
Newly Diagnosed Infection After Admission for Acute Heart Failure: From the KCHF Registry |
| title_short |
Newly Diagnosed Infection After Admission for Acute Heart Failure: From the KCHF Registry |
| title_full |
Newly Diagnosed Infection After Admission for Acute Heart Failure: From the KCHF Registry |
| title_fullStr |
Newly Diagnosed Infection After Admission for Acute Heart Failure: From the KCHF Registry |
| title_full_unstemmed |
Newly Diagnosed Infection After Admission for Acute Heart Failure: From the KCHF Registry |
| title_sort |
newly diagnosed infection after admission for acute heart failure: from the kchf registry |
| publisher |
Wiley |
| publishDate |
2021 |
| url |
https://doaj.org/article/3349956935b1400fa5e5f5d233e3e337 |
| work_keys_str_mv |
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