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New tool can identify heart failure patients at high risk of sepsis

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A tool has been developed by UK researchers to help identify heart failure patients at high risk of sepsis, which they say could catch cases early and save thousands of lives every year.

They highlighted that nearly one in four deaths in people with heart failure were currently caused by sepsis.

“We have created a simple way to identify people with heart failure who are at greatest risk of dying from sepsis”

Richard Cubbon

However, they said their study, funded by the British Heart Foundation, had revealed a way to identify patients who are most at risk, often years before they become ill.

The researchers said they hoped the tool will help clinicians determine which patients may benefit from closer monitoring and help to ensure they receive rapid treatment when they fall ill.

Around 550,000 people have been diagnosed with heart failure in the UK, but estimates suggest that in reality this figure is much higher.

Researchers from the University of Leeds tracked 1,802 patients with chronic heart failure from 2006 to 2014 for an average of four years.

They collected information about each patient at the beginning of the study. During the study, 737 patients died, with 173 (23.5%) deaths caused by sepsis.

“Sepsis is an important cause of death in these patients accounting for almost one in four deaths”

Nilesh Samani

The team analysed this data and found several distinct markers which flagged higher risk of death from sepsis specifically, rather than progressively worsening heart failure or sudden cardiac arrest.

Blood samples from high-risk patients contained lower levels of vitamin D and higher counts of platelets, according to the findings published in the Journal of the American Heart Association.

Those at high risk were also older, more likely to have chronic obstructive pulmonary disease and more likely to be male.

The researchers used this data to create a “risk profile” that they said could be used in future to flag patients at highest risk of dying from sepsis.

They said such patients could then receive counselling, closer monitoring in primary care and vaccines to prevent respiratory infections – the root cause of 70% of sepsis cases in the study.

Lead author Professor Richard Cubbon, from the University of Leeds said: “We have created a simple way to identify people with heart failure who are at greatest risk of dying from sepsis.”

He suggested that it could be part of routine checks that were already performed when heart failure patients visited their general practice.

He added: “With our risk profile, we hope people at high risk of sepsis will receive better monitoring, and infections which could lead to sepsis are treated early.”

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Nilesh Samani

Professor Sir Nilesh Samani, medical director at the British Heart Foundation, said: “This observational study re-emphasises that, despite modern treatments, people with heart failure have a prognosis that is worse than many cancers, with two out of five people dying within four years.

“The new finding here is that sepsis is an important cause of death in these patients accounting for almost one in four deaths,” said Professor Samani.

“We also now know that particular characteristics of the patients, some of which may be correctable, makes them more prone to developing sepsis,” he said.

“Further research is necessary but this study highlights potentially important ways in which we may be able to improve the outlook of patients with heart failure,” he added.

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