THE ASSOCIATION BETWEEN COMMUNITY-ACQUIRED PNEUMONIA AND CARDIAC COMPLICATIONS
*Dr. Talib Mutar Al- Janabi M. B. Ch. B, MD.
ABSTRACT
The community-acquired pneumonia (CAP) is globally spread disease and affects more than 5 million adults each year in the United States. Although incident cardiac complications occur in patients with community-acquired pneumonia, their incidence, risk factors, timing and associations with short-term mortality are not well understood. This prospective cohort study was carried out in the general hospital of Falluja/Iraq on a total of 200 patients, 134 inpatients and 66 outpatients, with community-acquired pneumonia and followed up prospectively for 30 days after presentation. Incident cardiac complications (new or worsening heart failure, new or worsening arrhythmias, or myocardial infarction) were diagnosed in 37 inpatients (28%) and 5 outpatients (8%). Although most events (89.2% in inpatients, 80% in outpatients) were diagnosed within the first week, more than half of them were recognized in the first 24 hours. Factors associated with their diagnosis included older age, pre-existing as DM, cerebrovascular disease, COPD, chronic renal disease, smoking, altered mental state, respiratory rate more than 30 per minute, pH less than 7.35, blood urea nitrogen ≥30 mg/dL, Glucose ≥250 mg/dL (14 mmol/L), Hematocrit <30%, Po2 <60 mm Hg or O2 sat <90 mm Hg, pleural effusion on chest x-ray, site of care and pneumonia severity index. Incident cardiac complications are common in patients with community-acquired pneumonia and are associated with increased short-term mortality. Older age, preexisting cardiovascular disease, and pneumonia severity are associated with their occurrence. Further studies are required to test risk stratification and prevention and treatment strategies for cardiac complications in this population.
Keywords: Community acquired pneumonia (CAP), cardiac diseases, cardiac complications.
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