Acute cardiac complications in patients admitted with Community-acquired pneumonia in an Internal Medicine ward

Abstract

Abstract 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.