Background 

Infection is the most common non-cardiovascular cause of re-hospitalizations for heart failure patients. We therefore investigated the predictors of infection-related re-hospitalization (IRRH) in heart failure patients and its impact on long-term survival.

Methods and Results 

We prospectively recruited 622 patients after the index hospitalization for decompensated heart fail with primary endpoints of IRRH and all-cause mortality. During follow-up of 3.9 ± 2.7 years, IRRHs occurred in 104 (16.7%) patients. Of the 104 patients who experienced IRRHs, the time from the index hospitalization to IRRH was 1.0 (interquartile range: 0.4–2.6) years. Independent predictors of IRRH were age (hazard ratio: 1.02, 95% confidence interval: 1.01–1.04), diabetes mellitus (2.12, 1.42–3.17), not taking angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (1.67, 1.01–2.78), needing maintenance therapy with a loop diuretic (2.10, 1.36–3.26), hemoglobin levels (0.87, 0.79–0.96), and estimated glomerular filtration rates (eGFRs) (0.99, 0.98–0.99). IRRH independently predicted all-cause mortality (1.99, 1.32–2.98) after adjusting for age, body mass index, New York Heart Association functional class, chronic obstructive pulmonary disease, brain natriuretic peptide, hemoglobin, and eGFR. The increased risk of death associated with IRRHs was predominantly for lower respiratory tract infections (3.71, 2.28–6.04), urogenital tract infections (2.83, 1.32–6.10), and sepsis (3.26, 1.20–8.85).

Conclusion 

IRRHs in patients discharged for acute decompensated heart fail independently predicted worse long-term survival. We further identified independent predictors of IRRHs. These findings warrant future studies for tackling IRRH.

中文翻译：

---

心力衰竭患者感染相关性再住院的预测因素及其对长期生存的影响

背景 

对于心力衰竭患者，感染是重新住院的最常见的非心血管原因。因此，我们研究了心力衰竭患者感染相关再住院（IRRH）的预测因素及其对长期生存的影响。

方法与结果 

我们在指数住院后因失代偿性心力衰竭而入选了622名患者，其主要终点指标为IRRH和全因死亡率。在3.9±2.7年的随访期间，IRRH发生在104例（16.7％）患者中。在经历过IRRH的104例患者中，从指数住院时间IRRH为1.0年（四分位数范围：0.4-2.6）年。IRRH的独立预测因素是年龄（危险比：1.02，95％置信区间：1.01-1.04），糖尿病（2.12，1.42-3.17），未服用血管紧张素转换酶抑制剂或血管紧张素II受体阻滞剂（1.67，1.01-2.78） ），需要使用loop利尿剂（2.10，1.36-3.26），血红蛋白水平（0.87，0.79-0.96）和估计的肾小球滤过率（eGFR）（0.99，0.98-0.99）进行维持治疗。IRRH独立预测全因死亡率（1.99，1.32–2.98）在调整了年龄，体重指数，纽约心脏协会功能等级，慢性阻塞性肺疾病，脑钠肽，血红蛋白和eGFR之后。与IRRH相关的死亡风险增加主要是下呼吸道感染（3.71、2.28–6.04），泌尿生殖道感染（2.83、1.32–6.10）和败血症（3.26、1.20–8.85）。

结论 

因急性失代偿性心力衰竭出院的患者的IRRHs独立预测较差的长期生存率。我们进一步确定了IRRH的独立预测因子。这些发现值得进一步研究以解决IRRH。