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Purpose <p>We investigated whether hemodynamic parameters measured in the acute phase of infections predict adverse outcomes in patients acutely hospitalized.</p> Methods <p>We studied 942 patients, who were admitted to the medical emergency room of a tertiary Danish hospital between 2021 and 2023. Patients were evaluated by physical examination, laboratory testing, and non-invasive hemodynamic evaluation using pulse-contour methodology. Primary outcome was death and unplanned readmission within 3&#xa0;months after discharge.</p> Results <p>Primary outcome was detected in 280 patients (30%). Patients admitted with infectious diseases (<i>n</i> = 120, 13%) had higher event rate (42%) than non-infected patients (28%, <i>p</i> = 0.005). In a Cox model adjusted for age, sex, high early warning score and Charlson Comorbidity Index, infectious diseases were associated with a higher 3-month rate of death and readmission: Hazard Ratio (HR): 1.41, (95% CI 1.05–2.00), <i>p</i> = 0.03. Systemic vascular resistance (SVR) was lower in patients with infectious diseases: (median 827 vs. 944 dyn*s/cm<sup>5</sup>, <i>p</i> = 0.022), which was not compensated by increased cardiac index (3.37 vs. 3.35&#xa0;l/m/m<sup>2</sup>, <i>p</i> = 0.91). In patients with infection, low SVR was associated with 22% increased risk of outcome per quintile decrease [adjusted HR 1.22 (1.01–1.51), <i>p</i> = 0.036].</p> Conclusions <p>Patients with acute infection exhibit a higher rate of death and readmission in the months after an index admission compared to non-infected patients. SVR was significantly reduced in patients with acute infection. Low SVR in patients with infection was associated with an adverse prognosis.</p> Trial registration <p>Information on the study is published in ClinicalTrials (NCT03934775). Registration date: 29-04-2019.</p>

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Prognostic value of systemic vascular resistance in acute infection

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月3日

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  • Rakin Hadad,
  • Emma H. J. Malm,
  • Philip L. Bonde,
  • Umema I. Ahmed,
  • Helena Dominguez,
  • Finn Erland Nielsen,
  • Steen B. Haugaard,
  • Ahmad Sajadieh

摘要

Purpose

We investigated whether hemodynamic parameters measured in the acute phase of infections predict adverse outcomes in patients acutely hospitalized.

Methods

We studied 942 patients, who were admitted to the medical emergency room of a tertiary Danish hospital between 2021 and 2023. Patients were evaluated by physical examination, laboratory testing, and non-invasive hemodynamic evaluation using pulse-contour methodology. Primary outcome was death and unplanned readmission within 3 months after discharge.

Results

Primary outcome was detected in 280 patients (30%). Patients admitted with infectious diseases (n = 120, 13%) had higher event rate (42%) than non-infected patients (28%, p = 0.005). In a Cox model adjusted for age, sex, high early warning score and Charlson Comorbidity Index, infectious diseases were associated with a higher 3-month rate of death and readmission: Hazard Ratio (HR): 1.41, (95% CI 1.05–2.00), p = 0.03. Systemic vascular resistance (SVR) was lower in patients with infectious diseases: (median 827 vs. 944 dyn*s/cm5, p = 0.022), which was not compensated by increased cardiac index (3.37 vs. 3.35 l/m/m2, p = 0.91). In patients with infection, low SVR was associated with 22% increased risk of outcome per quintile decrease [adjusted HR 1.22 (1.01–1.51), p = 0.036].

Conclusions

Patients with acute infection exhibit a higher rate of death and readmission in the months after an index admission compared to non-infected patients. SVR was significantly reduced in patients with acute infection. Low SVR in patients with infection was associated with an adverse prognosis.

Trial registration

Information on the study is published in ClinicalTrials (NCT03934775). Registration date: 29-04-2019.