Aykut Cilli1, Ozlem Cakin1, Emine Aksoy2, Feyza Kargin2, Nalan Adiguzel2, Zuhal Karakurt2, Begum Ergan3, Seda Mersin3, Selen Bozkurt1, Fatma Ciftci4, Melike Cengiz1. 1. Department of Respiratory Diseases, Akdeniz University, School of Medicine, Antalya, Turkey. 2. Sureyyapasa Thoracic Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey. 3. Department of Respiratory Diseases, Dokuz Eylul University, School of Medicine, Izmir, Turkey. 4. Department of Respiratory Diseases, Ankara University, School of Medicine, Ankara, Turkey.
Abstract
INTRODUCTION: An increased risk of cardiovascular complications has been defined in community-acquired pneumonia (CAP), but limited data is available for patients with severe CAP. OBJECTIVE: The aim of the present study was to define the prevalence, characteristics, risk factors and impact on mortality of acute cardiac events in patients with severe CAP during short and long term. METHOD: This investigation was a multicenter, retrospective cohort sudy of patients with severe CAP. Cardiac events were defined as cardiac arrhytmia, congestive heart failure and myocardial infarction. A logistic regression analysis was performed to identify predictors for acute cardiac events and mortality. RESULTS: Of 373 patients (mean age 68 ± 16, 61.4% male), 56 (15%) developed a cardiac event (43 arrhythmia, 11 congestive heart failure and 2 myocardial infarction). Patients who developed an acute cardiac event were older, had more severe disease, pleural effusion, hypoalbuminemia, hyponatremia and more acidosis. Also, beta-blocker and diuretic use were more significant in these patients. In-hospital mortality was significantly higher in patients who developed cardiac events (29.6% vs 11%, P < .001). According to the logistic regression analysis, haloperidol, vasopressor or diuretic use, hypoalbuminemia and age were the predictors for acute cardiac events. Acute cardiac events were significantly associated with in-hospital mortality (OR 2.1; 95%CI 1.03-4.61, P = .04), but not associated with 90-day mortality. CONCLUSION: Our findings demonstrated that acute cardiac events are seen in a substantial proportion of patients with severe CAP and their occurence significantly associated with in-hospital mortality.
INTRODUCTION: An increased risk of cardiovascular complications has been defined in community-acquired pneumonia (CAP), but limited data is available for patients with severe CAP. OBJECTIVE: The aim of the present study was to define the prevalence, characteristics, risk factors and impact on mortality of acute cardiac events in patients with severe CAP during short and long term. METHOD: This investigation was a multicenter, retrospective cohort sudy of patients with severe CAP. Cardiac events were defined as cardiac arrhytmia, congestive heart failure and myocardial infarction. A logistic regression analysis was performed to identify predictors for acute cardiac events and mortality. RESULTS: Of 373 patients (mean age 68 ± 16, 61.4% male), 56 (15%) developed a cardiac event (43 arrhythmia, 11 congestive heart failure and 2 myocardial infarction). Patients who developed an acute cardiac event were older, had more severe disease, pleural effusion, hypoalbuminemia, hyponatremia and more acidosis. Also, beta-blocker and diuretic use were more significant in these patients. In-hospital mortality was significantly higher in patients who developed cardiac events (29.6% vs 11%, P < .001). According to the logistic regression analysis, haloperidol, vasopressor or diuretic use, hypoalbuminemia and age were the predictors for acute cardiac events. Acute cardiac events were significantly associated with in-hospital mortality (OR 2.1; 95%CI 1.03-4.61, P = .04), but not associated with 90-day mortality. CONCLUSION: Our findings demonstrated that acute cardiac events are seen in a substantial proportion of patients with severe CAP and their occurence significantly associated with in-hospital mortality.
Authors: Hector F Africano; Cristian C Serrano-Mayorga; Paula C Ramirez-Valbuena; Ingrid G Bustos; Alirio Bastidas; Hernan A Vargas; Sandra Gómez; Alejandro Rodriguez; Carlos J Orihuela; Luis F Reyes Journal: Clin Infect Dis Date: 2021-06-01 Impact factor: 9.079