Cardiovascular complications in hospitalized patients with community-acquired pneumonia: retrospective cohort study
DOI:
https://doi.org/10.51481/amc.v59i3.967Keywords:
Community-acquired pneumonia, mortality, acute myocardial infarction, arrhythmia., heart failure, acute pulmonary edemaAbstract
Justification and objectives: Previous studies have demonstrated increased risk of cardiovascular events in patients with community-acquired pneumonia. The objective of this study is to characterize the population of patients diagnosed with community-acquired pneumonia and identify factors associated with the development of cardiovascular complications and 30-day mortality.
Methods: A retrospective observational case-control cohort was done, with cases and controls in the department of Internal Medicine at a tertiary level teaching hospital with patients diagnosed with community-acquired pneumonia. Clinical and laboratory variables of patients admitted were evaluated, also the clinical diagnosis of arrhythmia, acute myocardial infarction, heart failure (new or worsening), pulmonary edema and death within 30 days after admission (cases) or absence of these findings (controls).
Results: 35 cases of community-acquired pneumonia were identified on the first semester of 2015, of which 17 (48.57%) developed cardiovascular complications. Older patients, female sex, hypertension and ischemic heart disease demonstrated higher risk of cardiovascular events, as well as presenting the systolic blood pressure, creatine phosphokinase and urea nitrogen. The 22.85% of patients died within 30 days after being admitted; the risk of death was higher for patients with cardiovascular complications [Hazard ratio 8.8 (95% CI 1.08-71.66; p = 0.03)]. No association between the identified clinical differences and fatal outcome was found. Limitations: The retrospective nature of the study and the variables, which were collected from clinical records, depended entirely on the discretion of the treating physicians to request tests and variable allocation. The presence of confounding is possible due to unmeasured covariates or disease severity.
Conclusions: In patients admitted with a diagnosis of community-acquired pneumonia the development of cardiovascular complications was associated with increased mortality.
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