Abstract
BackgroundCommunity-acquired pneumonia (CAP) and acute myocardial infarction cardiovascular (AMI) are two important health issues in older patients. Little is known regarding characteristics of AMI in older patients hospitalized for CAP. Therefore, we investigated the prevalence, characteristics compared with younger patients, impact on clinical outcomes and risk factors of AMI during hospitalization for CAP in geriatric patients.MethodsEleven thousand nine adult inpatients consisted of 5111 patients≥65 years and 5898 patients< 65 years in respiratory ward diagnosed with CAP were retrospectively analyzed by electronic medical records.Results159 (3.1%) older patients in respiratory ward experienced AMI during hospitalization for CAP. AMI were more frequently seen in patients≥65 years compared with patients< 65 years (3.1% vs. 1.0%). Patients≥65 years who experienced AMI during hospitalization for CAP had higher percentage of respiratory failure (P = 0.001), hypertension (P = 0.008), dyspnea (P = 0.046), blood urea nitrogen (BUN) ≥7 mmol/L (P < 0.001), serum sodium< 130 mmol/L (P = 0.005) and had higher in-hospital mortality compared to patients< 65 years (10.1% vs. 6.6%). AMI was associated with increased in-hospital mortality (odds ratio, OR, with 95% confidence interval: 1.49 [1.24–1.82]; P < 0.01). Respiratory failure (OR, 1.34 [1.15–1.54]; P < 0.01), preexisting coronary artery disease (OR, 1.31[1.07–1.59]; P = 0.02), diabetes (OR, 1.26 [1.11–1.42]; P = 0.02) and BUN (OR, 1.23 [1.01–1.49]; P = 0.04) were correlated with the occurrence of AMI in the older patients after hospitalization with CAP.ConclusionsThe incidence of AMI during CAP hospitalization in geriatric patients is notable and have an impact on in-hospital mortality. Respiratory failure, preexisting coronary artery disease, diabetes and BUN was associated with the occurrence of AMI in the older patients after hospitalization with CAP. Particular attention should be paid to older patients with risk factors for AMI.
Highlights
Community-acquired pneumonia (CAP) and acute myocardial infarction cardiovascular (AMI) are two important health issues in older patients
Clinical characteristics of geriatric patients who experiencing AMI and those who without AMI during CAP hospitalization There were 5111 patients in the respiratory ward hospitalized for CAP and aged≥65 years, 159 experienced AMI during hospitalization
A high proportion of patients presenting chief complaint of chest pain or dyspnea (P = 0.030, P < 0.001, respectively), abnormal blood pressure (P < 0.001), body temperature (P = 0.003), heart rate ≥ 125 bpm (P < 0.001), blood urea nitrogen (BUN) ≥7 mmol/L (P < 0.001), blood platelet (PLT) < 10.0 × 109/L (P < 0.001), serum sodium< 130 mmol/L (P < 0.001) or blood glucose≥14 mmol/L (P < 0.001) on hospital admission was higher in patients who experiencing AMI compared with those who without AMI during hospitalized for CAP
Summary
Community-acquired pneumonia (CAP) and acute myocardial infarction cardiovascular (AMI) are two important health issues in older patients. Little is known regarding characteristics of AMI in older patients hospitalized for CAP. We investigated the prevalence, characteristics compared with younger patients, impact on clinical outcomes and risk factors of AMI during hospitalization for CAP in geriatric patients. Community-acquired pneumonia (CAP) and acute myocardial infarction cardiovascular (AMI) are two major public health issues in older patients. Mortality in geriatric patients with CAP may be 25% higher than in the general population [2, 3]. The incidence and mortality risk in CAP are linked to increasing age and the presence of age-related comorbidities and complications. There is a clear need to recognize the life-threatening complications among geriatric patients with CAP
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