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Background <p>Sepsis is a life-threatening dysregulated host response to microbial infection often leading to multiorgan failure and cardiovascular complications, which significantly contribute to mortality. This study aimed to identify key risk factors associated with disease severity among sepsis patients with distinct cardiovascular and metabolic comorbidities.</p> Methods <p>This hospital-based case-control study included 148 adult patients with sepsis admitted to the intensive care unit (ICU) and 311 non-septic controls with comparable cardiovascular and metabolic comorbidities. Sepsis was diagnosed based on clinical criteria and confirmed by elevated serum procalcitonin levels. Serum procalcitonin, IL-6, IL-10, and TNF-α were measured using chemiluminescent immunoassays. Associations between comorbidities and sepsis severity were evaluated using chi-square tests and logistic regression and survival among sepsis cases was explored using Kaplan–Meier analysis.</p> Results <p>Mostly infections were caused by Gram-negative bacteria, mainly <i>Klebsiella pneumoniae</i> and <i>Escherichia coli</i>. Elevated serum procalcitonin levels were used to support the diagnosis of sepsis. Compared with controls, sepsis patients showed significant increases in serum levels of IL-6, IL-10 and TNF-α, indicating an enhanced systemic inflammatory response. Statistical analysis showed that cardiovascular diseases, hypertension and type-2 diabetes were significantly associated with increased disease severity. Descriptive survival analyses among sepsis patients suggested lower survival probabilities in those with rheumatic heart disease and peripheral arterial disease.</p> Conclusions <p>Cardiovascular and metabolic comorbidities particularly myocardial infarction and type 2 diabetes mellitus are strongly associated with sepsis requiring intensive care. Elevated inflammatory cytokine levels characterize the systemic immune response in these patients. These findings highlight the importance of early risk stratification in septic patients with underlying cardiometabolic disease.</p> Graphical Abstract <p></p>

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Impact of cardiovascular and metabolic comorbidities on severity and outcomes of hospital-acquired sepsis in intensive care patients: a case–control study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月2日

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  • Amrita Roy,
  • Vignesh Krishnasamy,
  • Sourabh Mitra,
  • Sudip Banerjee,
  • Tapan Kumar Dutta,
  • Nachimuthu Senthil Kumar,
  • Swagnik Roy

摘要

Background

Sepsis is a life-threatening dysregulated host response to microbial infection often leading to multiorgan failure and cardiovascular complications, which significantly contribute to mortality. This study aimed to identify key risk factors associated with disease severity among sepsis patients with distinct cardiovascular and metabolic comorbidities.

Methods

This hospital-based case-control study included 148 adult patients with sepsis admitted to the intensive care unit (ICU) and 311 non-septic controls with comparable cardiovascular and metabolic comorbidities. Sepsis was diagnosed based on clinical criteria and confirmed by elevated serum procalcitonin levels. Serum procalcitonin, IL-6, IL-10, and TNF-α were measured using chemiluminescent immunoassays. Associations between comorbidities and sepsis severity were evaluated using chi-square tests and logistic regression and survival among sepsis cases was explored using Kaplan–Meier analysis.

Results

Mostly infections were caused by Gram-negative bacteria, mainly Klebsiella pneumoniae and Escherichia coli. Elevated serum procalcitonin levels were used to support the diagnosis of sepsis. Compared with controls, sepsis patients showed significant increases in serum levels of IL-6, IL-10 and TNF-α, indicating an enhanced systemic inflammatory response. Statistical analysis showed that cardiovascular diseases, hypertension and type-2 diabetes were significantly associated with increased disease severity. Descriptive survival analyses among sepsis patients suggested lower survival probabilities in those with rheumatic heart disease and peripheral arterial disease.

Conclusions

Cardiovascular and metabolic comorbidities particularly myocardial infarction and type 2 diabetes mellitus are strongly associated with sepsis requiring intensive care. Elevated inflammatory cytokine levels characterize the systemic immune response in these patients. These findings highlight the importance of early risk stratification in septic patients with underlying cardiometabolic disease.

Graphical Abstract