Key result
Prior HF in community-acquired pneumonia linked to ~170% greater acute cardiac event risk.
Why the study?
Community-acquired pneumonia is a frequent cause of hospital admission associated with acute cardiac events, but the incidence, risk factors, and impact on hospital stay and mortality required assessment.
Cohort (n=270)
No
Odds Ratio: 2.7 (95% CI 1.5–4.7)
Absolute Event Rate: 60.7% vs 30.1%
p-value: p=0.001
In elderly patients hospitalized with community-acquired pneumonia, acute cardiac events are highly frequent (43%) and significantly prolong hospital stay, with prior heart failure acting as a strong independent predictor.
Acute cardiac events in severe CAP raise in-hospital mortality risk; leaves open whether targeted monitoring or prevention alters outcomes.
BACKGROUNG: Community-acquired pneumonia (CAP) is one of the most frequent causes of hospital admission and it is associated with acute cardiac events. The goal was to assess the incidence, risk factors and impact of acute cardiac events on hospital stay and mortality in patients hospitalized due to CAP in 2018. METHODS: Cardiac complications were defined as: new or worsening heart failure, arrhythmia, or myocardial infarction. Statistical analysis was performed using SPSS. Factors with a univariate significance level of p < 0.10 were included in a multivariate regression model and odds ratios (OR) with 95% confidence intervals (CI) were calculated. P < 0.05 was considered statistically significant. RESULTS: 270 patients were included (median age: 84y). The most common comorbidities were arterial hypertension (76.3%) and chronic heart failure (40.4%). Forty-three percent of patients developed at least one cardiac complication. Mean CURB-65 score was 2.65 (SD 1.05) and 2.33 (SD 1.16) for patients with and without cardiac events, respectively. Mean duration of hospital stay was significantly higher in patients with cardiac complications (p = 0.01). There were no significant differences in hospital mortality. Factors included in the multivariate regression were previous history of heart failure, arterial hypertension or atrial fibrillation, blood urea nitrogen > 7mmol/L, age ≥ 65y, arterial pH < 7.35 and arterial pCO2 > 45mmHg. Previous history of heart failure was significantly associated with the incidence of acute cardiac events (OR 2.7; 95%CI 1.5–4.7). CONCLUSIONS: Cardiac events are frequent in CAP hospitalized patients and significantly increase the duration of hospital stay. CURB-65 score and previous history of heart failure are associated with this outcome.
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Farinha et al. (2023) conducted a cohort in Community-acquired pneumonia (n=270). Previous history of heart failure vs. No previous history of heart failure was evaluated on Onset of acute cardiac events (new or worsening heart failure, arrhythmias, or acute myocardial infarction) (OR 2.7, 95% CI 1.5-4.7, p=0.001). In patients hospitalized with community-acquired pneumonia, a previous history of heart failure was independently associated with a significantly increased risk of developing acute cardiac events (OR 2.7).
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