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

• Published in: QJM : An International Journal of Medicine Vol. 104; no. 6; pp. 489 - 495
• Main Authors: MANDAL, P, CHALMERS, J. D, CHOUDHURY, G, AKRAM, A. R, HILL, A. T
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.06.2011
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cerebrovascular Disorders - epidemiology; Cerebrovascular Disorders - etiology; Community-Acquired Infections - complications; Female; General aspects; Hospital Mortality; Humans; Length of Stay - statistics & numerical data; Logistic Models; Male; Medical sciences; Middle Aged; Outcome Assessment (Health Care); Pneumonia - complications; Pneumonia - mortality; Retrospective Studies; Risk Factors; Medicine; Lung disease; Pneumonia; Association; Community acquired infection; Prognosis; Respiratory disease; Blood vessel; Complication; Evolution; Circulatory system
• ISSN: 1460-2725; 1460-2393
• DOI: 10.1093/qjmed/hcq247

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.