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Risk stratification and prognosis of acute cardiac events in hospitalized adults with community-acquired pneumonia.
MedLine Citation:
PMID:  22981899     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To determine the risk factors and the prognosis of acute cardiac events in patients with community-acquired pneumonia (CAP). METHODS: Observational analysis of a prospective cohort of hospitalized adults with CAP (1995-2010). A logistic regression analysis was performed to identify predictors for acute cardiac events and mortality. RESULTS: Of 3921 patients with CAP, 315 (8%) had one or more acute cardiac events during hospitalization (199 new-onset or worsening cardiac arrhythmias, 118 new-onset or worsening congestive heart failure and/or 30 myocardial infarction). In the multivariate analysis, factors associated with these events were age >65 years, chronic heart disease, chronic kidney disease, tachycardia, septic shock, multilobar pneumonia, hypoalbuminemia, and pneumococcal pneumonia. A rule based on these variables had an area under ROC curve of 0.73 (95% CI 0.70-0.76) to predict acute cardiac events. These complications occurred in 2.8% of patients classified in the low-risk (≤3 points), 9.7% in the intermediate-risk (4-5 points) and 21.2% in the high-risk (≥6 points) groups (P < .001). The overall case fatality rate was higher in patients who had acute cardiac events (19.4% vs. 6.4%; P < .001). CONCLUSION: Acute cardiac events occur frequently during hospitalization for CAP and are associated with poor prognosis. A simple rule based on demographic and clinical features may help identify patients at higher risk of these complications.
Authors:
Diego Viasus; Carolina Garcia-Vidal; Frederic Manresa; Jordi Dorca; Francesc Gudiol; Jordi Carratalà
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-11
Journal Detail:
Title:  The Journal of infection     Volume:  -     ISSN:  1532-2742     ISO Abbreviation:  J. Infect.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7908424     Medline TA:  J Infect     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Ltd.
Affiliation:
Department of Infectious Diseases, Hospital Universitari de Bellvitge - IDIBELL, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain. Electronic address: dfviasusp@unal.edu.co.
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