Cardiac Complications in Patients With Community-Acquired Pneumonia

• DOI: 10.1161/circulationaha.111.040766
• Publication Date: 2012-01-06T01:15:04Z
• Authors: Vicente F. Corral...; Daniel M. Musher; George A. Wells; Julio A. Chirinos; Li Chen; Michael J. Fine
• Keywords: Adult; Aged, 80 and over; Heart Failure; Male; Inpatients; Incidence; Age Factors; Myocardial Infarction; Arrhythmias, Cardiac; Comorbidity; Middle Aged; Nursing Homes; 3. Good health; Community-Acquired Infections; 03 medical and health sciences; 0302 clinical medicine; Outpatients; Humans; Multicenter Studies as Topic; Female; Mortality; Aged; Follow-Up Studies

Background— Community-acquired pneumonia (CAP) affects >5 million adults each year in the United States. Although incident cardiac complications occur patients with community-acquired pneumonia, their incidence, timing, risk factors, and associations short-term mortality are not well understood. Methods Results— A total of 1343 inpatients 944 outpatients were followed up prospectively for 30 days after presentation. Incident (new or worsening heart failure, new arrhythmias, myocardial infarction) diagnosed 358 (26.7%) 20 (2.1%). most events (89.1% inpatients, 75% outpatients) within first week, more than half them recognized 24 hours. Factors associated diagnosis included older age (odds ratio [OR]=1.03; 95% confidence interval [CI], 1.02–1.04), nursing home residence (OR, 1.8; CI, 1.2–2.9), history failure 4.3; 3.0–6.3), prior arrhythmias 1.2–2.7), previously coronary artery disease 1.5; 1.04–2.0), arterial hypertension 1.1–2.1), respiratory rate ≥30 breaths per minute 1.6; 1.1–2.3), blood pH <7.35 3.2; 1.8–5.7), urea nitrogen mg/dL 1.1–2.2), serum sodium <130 mmol/L 1.02–3.1), hematocrit <30% 2.0; 1.3–3.2), pleural effusion on presenting chest x-ray 1.1–2.4), inpatient care 4.8; 2.8–8.3). increased death at adjustment baseline Pneumonia Severity Index score 1.04–2.5). Conclusions— common mortality. Older age, residence, preexisting cardiovascular disease, severity occurrence. Further studies required to test stratification prevention treatment strategies this population.