Sepsis After Elective Aortic Root Replacement: An Analysis Using the National Inpatient Sample.

Area of Science:

• Cardiovascular Surgery
• Infectious Disease Epidemiology
• Health Services Research

Background:

• Sepsis following aortic root replacement (ARR) presents a significant risk for mortality.
• Identifying risk factors for post-ARR sepsis is crucial for improving patient outcomes.
• Previous studies have not thoroughly investigated these specific risk factors.

Purpose of the Study:

• To identify risk factors associated with sepsis development after elective aortic root replacement.
• To analyze patient demographics, comorbidities, and health factors influencing sepsis risk.
• To provide data for targeted interventions to reduce sepsis incidence.

Main Methods:

• Utilized the National Inpatient Sample (NIS) database from 2017-2022.
• Included adult patients (≥18 years) undergoing elective ARR.
• Employed multivariable logistic regression to analyze risk factors.

Main Results:

• Sepsis occurred in 2.1% of 66,530 patients undergoing elective ARR.
• Risk factors for sepsis included weight loss/cachexia, neurologic disorders, renal failure, heart failure, liver disease, chronic lung disease, cerebrovascular disease, aortic dissection, and coagulopathy.
• Protective factors against sepsis included thoracic aortic aneurysm, hypertension, hyperlipidemia, and tobacco use.

Conclusions:

• Healthcare professionals must recognize sepsis risk factors and protective characteristics post-ARR.
• Preoperative optimization of modifiable risk factors is recommended for high-risk patients.
• Awareness of these factors can guide strategies to minimize postoperative sepsis risk.