Outcome of community-acquired pneumonia with cardiac complications

Background: Although pneumonia is a leading cause of death, little consideration has been given to understanding the contributors to this mortality. Previous studies have suggested an increased mortality in pneumonia patients who develop cardiac complications. The aim of this study was to examine the risk factors and outcome of cardiac complications in admitted patients with community-acquired pneumonia. Patients and methods: This study included 130 patients hospitalized with a primary diagnosis of community-acquired pneumonia. All patients were subjected to complete medical history, general and local chest examination, Laboratory investigations (complete blood count, renal and hepatic function tests, serum electrolytes, blood sugar, arterial blood gas analysis, CRP, procalcitonin, BNP, cardiac enzymes, blood and sputum Gram stain and culture, sputum PCR for Mycoplasma pneumoniae, Legionella pneumophila, Coxiella burnetii, and Chlamydophila species, urine antigen testing for S. pneumoniae and L. pneumophila, pharyngeal swabs for viral PCR.), radiological investigations, electrocardiographic studies (ECG) and echocardiography. Results: Among the studied 130 patients, 32 patients (24.6%) had cardiac complications [ new or worsening heart failure in16 patients (12.3%), arrhythmias in 12 patients (9.2%), and acute myocardial infarction in 4 patients (3.1%)]. In comparing patients who developed cardiac complications with those who did not they had a significantly higher age (mean +/- SD 69 +/- 17.3 versus 49 +/- 19.1, p < 0.05), included a significantly higher percentage of patients with preexisting cardiovascular diseases (40.6% versus 5.1%, p < 0.05), had a significantly higher pneumonia severity index (PSI) (mean +/- SD 130 +/- 27 versus 73 +/- 29, p < 0.05), a significantly longer hospital stay (mean +/- SD 22 +/- 7.1 versus 9 +/- 4.3, P < 0.05) and a significantly higher mortality (21.8% versus 6.1%, P< 0.05). Conclusions: Cardiac complications are common in the admitted patients with pneumonia and they are associated with increased pneumonia severity and increased cardiovascular risk, these complications adds to the risk of mortality, so optimal management of these events may reduce the burden of death associated with this infection. (C) 2015 The Authors. Production and hosting by Elsevier B.V.