Hello! I am Liu Jian
Today is the 545th issue that Jian Ge said to accompany you
Recently, there was a news story about former US President Bill Clinton being hospitalized for sepsis, and some people were concerned about the disease of sepsis. What I am concerned about is that as a postoperative patient of coronary artery bypass surgery and coronary stent surgery, the former president of the United States may have buried many hidden dangers for his health even if he is cured of sepsis.
Sepsis of infection
Many people don't know what sepsis is, but the name doesn't sound good.
Sepsis refers to the acute systemic infection that occurs when pathogenic bacteria invade the blood circulation, grow and multiply in the blood, and produce toxins, sepsis can lead to excessive physical response and trigger too many highly destructive immune reactions, even life-threatening.
Therefore, the essence of sepsis is infection. Initially, pathogenic bacteria only invade human skin or mucous membranes to cause local inflammation, but as the infection worsens, the bacterial emboli migrate with the blood flow, causing multiple infections throughout the body, resulting in chills, high fever, rash, hepatosplenomegaly and elevated white blood cells. Sepsis is more like an "extreme reaction" of the body to fight infections that lead to both defeats. Unless diagnosed and treated in time, it is easy to quickly develop multiple organ failure and die.
The case fatality rate for sepsis is high
The pathogen that causes sepsis can be bacteria, viruses, fungi, etc. Infections usually begin in the lungs, urinary tract, skin, or gastrointestinal tract. People over the age of 65, people with weakened immune systems, and people with chronic diseases such as diabetes and cancer are more likely to develop sepsis.
The mortality rate of sepsis is very high, and sepsis is becoming more and more common in the clinic. The data shows that in 2017 alone, 11 million people died from sepsis worldwide, compared to 56 million deaths this year, in other words, sepsis accounts for 20% of all deaths [1]. There is no detailed data on sepsis patients in China, and it is estimated that about 3 million people suffer from sepsis every year, and 500,000 people die from sepsis.
Heart hazards of sepsis
Sepsis, a systemic infectious disease, its damage to the cardiovascular system, is also beyond doubt.
Studies have found that sepsis increases the risk of cardiovascular diseases such as myocardial infarction, acute heart failure, atrial fibrillation, etc. A foreign study found that [2] the risk of future heart attacks or deaths from heart attacks in sepsis doubled compared to those who had not experienced sepsis.
Another meta-analysis of 27 studies found that sepsis may be a long-term risk factor for cardiovascular disease, comparable to the risk of traditional cardiovascular risk factors such as hypertension, dyslipidemia, and diabetes, and that this potential risk remains high for at least five years after discharge [3].
In patients with heart failure with poor heart pumping function, sepsis may be more severe after sepsis, and studies have found that sepsis may account for nearly one-fourth of the deaths in patients with heart failure [4].
This may be because, when an infection occurs, the blood vessels in the human body dilate, which is an overreaction to the invasion of pathogens in the blood, which can lead to a drop in blood pressure, the heart needs to work harder to ensure the supply of blood oxygen to vital organs, and the load on the heart increases. In addition, toxins in the blood system can damage the lining of blood vessels, increasing the risk of thrombosis, and inflammation caused by infection can also aggravate atherosclerosis. Elderly patients who already have heart disease are more likely to cause multi-organ failure and even life-threatening if they have a systemic infection.
If infection is the "spark of a spark", then cardiovascular disease gives it the basis for "burning the plains". Therefore, heart disease patients should pay attention to the prevention of infection, if suffering from infectious diseases, such as respiratory infections, lung infections, urinary tract infections, etc., must not be careless, should be actively treated, anti-micro gradual, do not give sepsis an opportunity.
Brother Jian said
Sepsis is a systemic infection caused by pathogenic bacteria and is susceptible to life-threatening diseases.
Sepsis is very common in the clinic, and the case fatality rate is very high, which needs to be paid more attention.
Suffering from sepsis will increase the risk of cardiovascular disease and death, heart disease patients should pay attention to the prevention of infection, if infectious diseases occur, should be actively treated to avoid serious consequences.
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bibliography
[1] Kempker JA, Martin GS. A global accounting of sepsis. Lancet. 2020 Jan 18;395(10219):168-170.
[2] Wang HE, Moore JX, Donnelly JP, et al. Risk of Acute Coronary Heart Disease After Sepsis Hospitalization in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Cohort. Clin Infect Dis. 2017 Jul 1;65(1):29-36.
[3] Kosyakovsky LB, Angriman F , Katz E, et al. Association between sepsis survivorship and long-term cardiovascular outcomes in adults: a systematic review and meta analysis. Intensive Care Med. 2021;47:931–42.
[4] Walker AMN, Drozd M, Hall M, et al. Prevalence and Predictors of Sepsis Death in Patients With Chronic Heart Failure and Reduced Left Ventricular Ejection Fraction. J Am Heart Assoc. 2018;7(20):e009684.
Speaker: Liu Jian
Editor-in-Charge: Tan Suzhen