P Mandal1, J D Chalmers, G Choudhury, A R Akram, A T Hill. 1. Department of Respiratory Medicine, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA, UK. pallavimandal@googlemail.com
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.
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.
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