Article

Vascular complications are associated with poor outcome in community-acquired pneumonia.

Department of Respiratory Medicine, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA, UK.
QJM: monthly journal of the Association of Physicians (impact factor: 2.33). 01/2011; 104(6):489-95. DOI:10.1093/qjmed/hcq247 pp.489-95
Source: PubMed

ABSTRACT Recognition of cardiovascular risk factors is important for primary and secondary prevention strategies. Recent evidence has linked lower respiratory tract infections with the development of acute myocardial infarction.
The aim of this study was to determine the frequency of cardiovascular and cerebrovascular events and the clinical outcomes, during hospitalization for community-acquired pneumonia (CAP).
We performed a retrospective study of 4408 patients with CAP presenting to five hospitals over a 2-year period. Clinical information, co-morbidities, cardiovascular events and 90-day mortality were collected from review of medical case notes. The relationship between cardiovascular events and outcomes were analysed using multivariable logistic regression.
From a total of 4408 patients, 2.2% developed stroke, 5% acute coronary syndrome or myocardial infarction and 9.3% new onset atrial fibrillation. These were associated with increased 90-day mortality [odds ratio (OR), 1.49 95% CI 1.18-1.87, P=0.0006]. Vascular events were independently associated with increased length of hospital stay-median 12 days (IQR 5-22), compared to patients with no vascular events 8 days (IQR 3-17 days, P<0.0001).
Cardiovascular and cerebrovascular events are common during hospitalization for CAP and are associated with increased 90-day mortality.

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Keywords

2-year period
 
5% acute coronary syndrome
 
9.3% new onset atrial fibrillation
 
90-day mortality
 
90-day mortality [odds ratio
 
acute myocardial infarction
 
cardiovascular events
 
cardiovascular risk factors
 
cerebrovascular events
 
Clinical information
 
clinical outcomes
 
community-acquired pneumonia
 
hospital stay-median 12 days
 
hospitalization
 
lower respiratory tract infections
 
medical case notes
 
multivariable logistic regression
 
retrospective study
 
secondary prevention strategies
 
vascular events 8 days