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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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-11-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.023256 |
| _version_ | 1797606916867751936 |
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| 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 |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-11T05:23:37Z |
| format | Article |
| id | doaj.art-3349956935b1400fa5e5f5d233e3e337 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-11T05:23:37Z |
| publishDate | 2021-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-3349956935b1400fa5e5f5d233e3e3372023-11-17T17:40:30ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-11-01102210.1161/JAHA.121.023256Newly Diagnosed Infection After Admission for Acute Heart Failure: From the KCHF RegistryYuta Seko0Takao Kato1Takeshi Morimoto2Hidenori Yaku3Yasutaka Inuzuka4Yodo Tamaki5Neiko Ozasa6Masayuki Shiba7Erika Yamamoto8Yusuke Yoshikawa9Yugo Yamashita10Takeshi Kitai11Ryoji Taniguchi12Moritake Iguchi13Kazuya Nagao14Toshikazu Jinnai15Akihiro Komasa16Ryusuke Nishikawa17Yuichi Kawase18Takashi Morinaga19Mamoru Toyofuku20Yutaka Furukawa21Kenji Ando22Kazushige Kadota23Yukihito Sato24Koichiro Kuwahara25Takeshi Kimura26Department of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto JapanDepartment of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto JapanClinical Epidemiology Hyogo College of Medicine Nishinomiya JapanDepartment of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto JapanCardiovascular Medicine Shiga General Hospital Moriyama JapanDivision of Cardiology Tenri Hospital Tenri JapanDepartment of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto JapanDepartment of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto JapanDepartment of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto JapanDepartment of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto JapanDepartment of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto JapanDepartment of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita JapanDepartment of Cardiology Hyogo Prefectural Amagasaki General Medical Center Amagasaki JapanDepartment of Cardiology National Hospital Organization Kyoto Medical Center Kyoto JapanDepartment of Cardiology Osaka Red Cross Hospital Osaka JapanDepartment of Cardiology Japanese Red Cross Otsu Hospital Otsu JapanDepartment of Cardiology Kansai Electric Power Hospital Osaka JapanDepartment of Cardiology Shizuoka General Hospital Shizuoka JapanDepartment of Cardiology Kurashiki Central Hospital Kurashiki JapanDepartment of Cardiology Kokura Memorial Hospital Kitakyushu JapanDepartment of Cardiology Japanese Red Cross Wakayama Medical Center Wakayama JapanDepartment of Cardiovascular Medicine Kobe City Medical Center General Hospital Kobe JapanDepartment of Cardiology Kokura Memorial Hospital Kitakyushu JapanDepartment of Cardiology Kurashiki Central Hospital Kurashiki JapanDepartment of Cardiology Hyogo Prefectural Amagasaki General Medical Center Amagasaki JapanDepartment of Cardiovascular Medicine Shinshu University Graduate School of Medicine Matsumoto JapanDepartment of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto JapanBackground 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.https://www.ahajournals.org/doi/10.1161/JAHA.121.023256acute heart failureheart failureinfectionsmortality |
| spellingShingle | 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 Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease acute heart failure heart failure infections mortality |
| title | 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_short | 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 |
| topic | acute heart failure heart failure infections mortality |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.023256 |
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