Association of pre-exiting heart failure with long-term mortality and the recurrence of sepsis

Sci Rep. 2025 Jan 2;15(1):343. doi: 10.1038/s41598-024-83443-y.

Abstract

This retrospective cohort study aimed to evaluate the association between pre-existing heart failure and both mortality and the recurrence of sepsis. A total of 16,092 sepsis patients without a history of heart failure and 841 sepsis patients with pre-existing heart failure were identified from the Medical Information Mart for Intensive Care version IV (MIMIC-IV ) database. All patients were adults admitted to intensive care units, and no specific interventions were applied. After matching, Kaplan-Meier survival analysis showed significantly poorer long-term survival rates in patients with heart failure, both in the original (p < 0.0001) and the matched cohort (p = 0.00059). Mortality rates were tracked over different time periods, revealing that the mortality disparity became evident after the first year (p = 0.029). Besides, the cumulative incidence of sepsis recurrence was substantially higher in patients with a history of heart failure (p < 0.001) when deaths without recurrence were treated as competing events. Moreover, there was no statistically significant difference observed in the deaths without recurrence between the two groups (p = 0.251). In conclusion, pre-existing heart failure is associated with an increased risk of long-term mortality, which may be partly explained by a higher incidence of recurrent sepsis in this population.

Keywords: Heart failure; Mortality; Recurrence; Risk factor; Sepsis.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Heart Failure* / mortality
  • Humans
  • Intensive Care Units
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Recurrence*
  • Retrospective Studies
  • Risk Factors
  • Sepsis* / complications
  • Sepsis* / mortality
  • Survival Rate