BHF scientists develop tool for spotting deadly sepsis in people who have heart failure

5 October 2018        

Category: Research

Nearly one in four deaths in people with heart failure are caused by sepsis, according to new research published today in the Journal of the American Heart Association.

scene of intensive care unit, man in bed

Researchers we fund have developed a way to identify patients who are most at risk, often years before they become ill.

The team hope the tool will help doctors determine which patients may benefit from closer monitoring and help to ensure they receive rapid treatment when they fall ill. Sepsis is a very serious complication of an infection. Without treatment it can lead to multiple organ failure and death. Catching cases early could save thousands of lives every year.

1 in 4 deaths

Professor Richard Cubbon, from the University of Leeds who led the study said, “We have created a simple way to identify people with heart failure who are at greatest risk of dying from sepsis. It could be part of a routine check which is already performed when they visit their doctors."

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.”

550,000 people in the UK have been diagnosed with heart failure, but estimates suggest there may be many more cases.

Heart failure occurs when the heart is not pumping blood around the body as well as it should, most commonly when the heart muscle has been damaged – for example, after a heart attack. Around 550,000 people have been diagnosed with heart failure in the UK, but estimates suggest that in reality this figure is much higher. The debilitating condition causes breathlessness, fatigue and premature death. People who have heart failure are also more vulnerable to potentially deadly infections.

Researchers from the University of Leeds tracked 1,802 patients with chronic heart failure from 2006 to 2014 for an average of four years. The scientists collected information about each patient at the beginning of the study. During the study, 737 patients died, with 173 (23.5 per cent) deaths caused by sepsis.

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 - cells which help blood clot. Those at high risk were also older, more likely to have chronic lung disease (chronic obstructive pulmonary disease) and more likely to be male.

The researchers used this data to create a ‘risk profile’ which could be used in future to flag patients at highest risk of dying from sepsis. These patients could receive counselling, closer monitoring by their GP and vaccines to prevent respiratory infections – the root cause of 70 per cent of sepsis cases in the study.

Sepsis, sometimes called blood poisoning, occurs when the immune system goes into overdrive in response to an infection and starts attacking the body's own cells, causing damage to vital organs. It can take hold quickly and, without rapid treatment, can lead to multiple organ failure and death.

Our medical director Professor Sir Nilesh Samani, Medical Director at the British Heart Foundation also commented on the study.

"This observational study re-emphasises that, despite modern treatments, people with heart failure have a prognosis that is worse than many cancers with 2 out of 5 people dying within 4 years.

"The new finding here is that sepsis is an important cause of death in these patients accounting for almost 1 in 4 deaths. We also now know that particular characteristics of the patients, some of which may be correctable, makes them more prone to developing sepsis.

"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."