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

QJM. 2011 Jun;104(6):489-95. doi: 10.1093/qjmed/hcq247. Epub 2011 Jan 7.

Abstract

Background: 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.

Aim: 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).

Design: 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.

Results: 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).

Conclusion: Cardiovascular and cerebrovascular events are common during hospitalization for CAP and are associated with increased 90-day mortality.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology*
  • Cerebrovascular Disorders / epidemiology
  • Cerebrovascular Disorders / etiology*
  • Community-Acquired Infections / complications
  • Female
  • Hospital Mortality
  • Humans
  • Length of Stay / statistics & numerical data
  • Logistic Models
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Pneumonia / complications*
  • Pneumonia / mortality
  • Retrospective Studies
  • Risk Factors