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Cardiovascular Complications in Septic Diabetics
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A3336 - Cardiovascular Complications in Septic Diabetics
Author Block: R. C. Wilson1, C. Pendley1, R. L. Wilson1, B. Varghese2, G. Patel2, R. A. Balk3; 1Internal Medicine, Rush University Medical Center, Chicago, IL, United States, 2Rush University Medical Center, Chicago, IL, United States, 3Pulmonary and Critical Care Medicine, Rush University Medical Center, Chicago, IL, United States.
Diabetes is one of the most common medical illnesses and has been rising in incidence and is associated with a number of complications. Cardiovascular complications and infections are leading causes of morbidity and mortality among diabetics. For this reason, there is a need to further explore cardiovascular morbidities as they relate to sepsis in diabetics.
In our study, we explored the incidence of cardiovascular morbidities in a population of patients admitted to a medical intensive care unit for sepsis. Acute cardiovascular events quantified included: new onset pulmonary embolism, acute coronary syndromes and ischemic events, cerebrovascular accidents, exacerbations of congestive heart failure/ new onset heart failure, pericardial disorders, ventricular arrhythmias, acute valvular dysfunction, acute myocardial disorders and acute aortic events . The primary endpoint measured was relative risk of new onset cardiovascular events in diabetics compared to non-diabetics. Secondary endpoints included in-hospital mortality and length of hospital stay. We hypothesized that diabetics would have an increased incidence of acute cardiovascular events. A retrospective review of the electronic medical record was done for these parameters among a group of 8840 septic patients.
We found that the most common cardiovascular event for both groups was acute coronary syndrome. There was no difference in overall mortality (p = 0.112) or total cardiovascular events (p = 0.848) between the diabetic (N = 3147) and non-diabetic (N = 5693) groups. The overall incidence of total cardiac events in our populations were 0.4% for both groups. Although over 300 ICD codes for cardiac events were queried, the only events found in our population were acute coronary syndromes and acute pulmonary emboli. Diabetics were more likely to have acute coronary syndromes than non-diabetics (RR 1.25). Conversely non-diabetics had a higher incidence of pulmonary embolism than diabetics (RR 1.67). These results suggest that all patients with sepsis have highest risk of acute coronary syndrome compared with other cardiac events and that diabetics with sepsis have the highest risk of acute myocardial infarction. Moreover, septic patients are most at risk for acute coronary syndromes and acute pulmonary embolism, compared with other cardiovascular events.
Author Block: R. C. Wilson1, C. Pendley1, R. L. Wilson1, B. Varghese2, G. Patel2, R. A. Balk3; 1Internal Medicine, Rush University Medical Center, Chicago, IL, United States, 2Rush University Medical Center, Chicago, IL, United States, 3Pulmonary and Critical Care Medicine, Rush University Medical Center, Chicago, IL, United States.
Diabetes is one of the most common medical illnesses and has been rising in incidence and is associated with a number of complications. Cardiovascular complications and infections are leading causes of morbidity and mortality among diabetics. For this reason, there is a need to further explore cardiovascular morbidities as they relate to sepsis in diabetics.
In our study, we explored the incidence of cardiovascular morbidities in a population of patients admitted to a medical intensive care unit for sepsis. Acute cardiovascular events quantified included: new onset pulmonary embolism, acute coronary syndromes and ischemic events, cerebrovascular accidents, exacerbations of congestive heart failure/ new onset heart failure, pericardial disorders, ventricular arrhythmias, acute valvular dysfunction, acute myocardial disorders and acute aortic events . The primary endpoint measured was relative risk of new onset cardiovascular events in diabetics compared to non-diabetics. Secondary endpoints included in-hospital mortality and length of hospital stay. We hypothesized that diabetics would have an increased incidence of acute cardiovascular events. A retrospective review of the electronic medical record was done for these parameters among a group of 8840 septic patients.
We found that the most common cardiovascular event for both groups was acute coronary syndrome. There was no difference in overall mortality (p = 0.112) or total cardiovascular events (p = 0.848) between the diabetic (N = 3147) and non-diabetic (N = 5693) groups. The overall incidence of total cardiac events in our populations were 0.4% for both groups. Although over 300 ICD codes for cardiac events were queried, the only events found in our population were acute coronary syndromes and acute pulmonary emboli. Diabetics were more likely to have acute coronary syndromes than non-diabetics (RR 1.25). Conversely non-diabetics had a higher incidence of pulmonary embolism than diabetics (RR 1.67). These results suggest that all patients with sepsis have highest risk of acute coronary syndrome compared with other cardiac events and that diabetics with sepsis have the highest risk of acute myocardial infarction. Moreover, septic patients are most at risk for acute coronary syndromes and acute pulmonary embolism, compared with other cardiovascular events.
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