Abstract Rationale Pulmonary edema is characterized by fluid accumulation in the lung. Pulmonary edema could be secondary to cardiogenic or non-cardiogenic etiology. Given that pulmonary edema may compromise the pulmonary function and alter the pulmonary microbiota, bacterial pneumonia remains a significant concern for healthcare professionals. Research Question We hypothesize that Pulmonary edema triggers inflammation or suppresses immune mechanisms which would increase the risk for bacterial pneumonia. Methods We conducted a cross-sectional study examining the association between pulmonary edema and pneumonia using All of Us research database version 8 and ICD code 9/10. Multivariable logistic regression models were employed to estimate odds ratios (OR) with 95% confidence intervals (CI), adjusting for age, race, ethnicity, and sex. Results The study included 371,398 patients, of whom 6,365 (1.7%) had pulmonary edema. Patients with pulmonary edema were older (mean age 64.6 ± 14.1 vs 56.6 ± 16.7 years, p 0.001) and more likely to be male (47.0% vs 37.4%, p 0.001). The prevalence of pneumonia was substantially higher among patients with pulmonary edema (16.4%) compared to those without (1.3%, p 0.001). In univariable analysis, pulmonary edema was strongly associated with pneumonia (OR 14.66, 95% CI: 13.63-15.75, p 0.001). After adjusting for demographic factors, this association remained robust (aOR 12.36, 95% CI: 11.48-13.29, p 0.001). We observed a significant age gradient in pneumonia risk, with patients aged ≥65 years having the highest adjusted odds compared to those aged 18-34 years (aOR 2.68, 95% CI: 2.38-3.02, p 0.001). Black patients showed higher adjusted odds of pneumonia compared to White patients (aOR 1.31, 95% CI: 1.22-1.41, p 0.001), while Asian patients had lower odds (aOR 0.67, 95% CI: 0.53-0.83, p = 0.001). Males demonstrated higher adjusted odds of pneumonia compared to females (aOR 1.27, 95% CI: 1.21-1.34, p 0.001). Clinical Implication Our study shows that pulmonary edema is significantly associated with an increased risk of pneumonia. These findings highlight the need for larger studies and emphasize the importance of staying up to date with vaccinations. We also observed racial differences in pneumonia risk, which rise with age as immunity declines. Patients with heart failure, end-stage renal disease, or other causes of non-cardiogenic pulmonary edema require close monitoring and early treatment to prevent severe pneumonia. This abstract is funded by: None
Chirackal et al. (Fri,) studied this question.