In-hospital outcomes of sepsis hospitalizations among patients with cardiac amyloidosis: A 2022 National inpatient sample analysis

Department

Cardiology

Document Type

Article

Publication Title

Current Problems in Cardiology

Abstract

Background: Cardiac amyloidosis is characterized by restrictive physiology and limited hemodynamic reserve. Sepsis management often relies on aggressive fluid resuscitation, which may pose risks in patients with noncompliant ventricles and fixed stroke volume. Whether cardiac amyloidosis independently worsens sepsis outcomes remains unknown.

Objectives: To evaluate the association between cardiac amyloidosis and outcomes in adults admitted with primary sepsis.

Methods: Adults with primary sepsis were identified in the 2022 National Inpatient Sample. Patients with and without cardiac amyloidosis were compared using ICD-10-CM codes. The primary outcome was in-hospital mortality. Survey-weighted multivariable logistic regression adjusted for demographics, comorbidity burden, and hospital characteristics was performed, with propensity matching as sensitivity analysis.

Results: Among 477,039 unweighted sepsis admissions, 500 had cardiac amyloidosis. In-hospital mortality was higher with cardiac amyloidosis than without (22.4% vs 10.7%; P < 0.001). After adjustment, cardiac amyloidosis was associated with higher odds of mortality (aOR 1.66; 95% CI 1.34-2.05), cardiogenic shock (aOR 4.32; 95% CI 3.13-5.98), cardiac arrest (aOR 1.57; 95% CI 1.06-2.32), and mechanical ventilation (aOR 1.28; 95% CI 1.01-1.64). Findings were consistent after propensity matching.

Conclusions: Among adults hospitalized for sepsis, cardiac amyloidosis was associated with higher in-hospital mortality and higher odds of cardiogenic shock and cardiac arrest.

First Page

103404

DOI

10.1016/j.cpcardiol.2026.103404

Volume

51

Issue

10

Publication Date

10-1-2026

Publisher

Mosby-Year Book

Medical Subject Headings

Humans; Female; Hospital Mortality; Sepsis; Amyloidosis; Male; United States; Aged; Cardiomyopathies; Middle Aged; Inpatients; Hospitalization; Retrospective Studies; Risk Factors

PubMed ID

42471103

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