Researchers reported that patients with pulmonary arterial hypertension (PAH) have poorer outcomes for acute heart failure in sepsis or septic shock, according to a study published in BMC Pulmonary Medicine. 

Studies demonstrate that patients with PAH and other comorbidities have poorer survival. In particular, infection leading to sepsis is a major risk for decompensated right heart failure, which can often be fatal. However, other studies suggest that patients with PAH do not suffer from higher risk of death within 30 days of sepsis or pneumonia. 

The authors of the current study set out to understand the impact of PAH in patients with sepsis/septic shock. To carry out their study, they retrieved clinical records from the Nationwide Readmission Database from 2016 and 2017. This database contains inpatient records representing 58% of hospitalizations from 28 states in the United States. The patients included in the study all received a diagnosis of sepsis/septic shock and PAH. 


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A total of 1129 patients were identified as diagnosed with sepsis/septic shock during their hospital stay with concurrent PAH. The research team discovered that patients with both sepsis and PAH had a higher prevalence of chronic conditions such as congestive heart failure, chronic pulmonary disease, and kidney failure, among other issues, compared with patients with sepsis only. 

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In addition, the authors reported that patients with both sepsis and PAH had longer hospital stays and greater healthcare utilization compared with patients with sepsis only. However, in terms of clinical outcomes, patients with sepsis and PAH did not have a higher risk of worse clinical outcomes compared with patients with sepsis only, except in regard to acute heart failure. 

“Patients with PAH are a vulnerable group, especially above the age of 50 years, since they have greater comorbidities, particularly relating to the heart,” the authors wrote. “Our findings reflect such a risk of decompensation with a higher occurrence of acute heart failure in patients with PAH who get admitted for [sepsis/septic shock].” 

Reference

Vasudeva R, Challa A, Tuck N, Pothuru S, Vindhyal M. Hospital outcomes for patients with pulmonary arterial hypertension in sepsis and septic shockBMC Pulm Med. 2022;22(1):374. doi:10.1186/s12890-022-02145-1