title: Vascular complications are associated with poor outcome in community-acquired pneumonia.
abstract: BACKGROUND
  Recognition of cardiovascular risk factors is important for primary and secondary prevention strategies. Recent evidence has linked lower respiratory tract infections with the development of acute myocardial infarction.
  
  
  OBJECTIVE
  The aim of this study was to determine the frequency of cardiovascular and cerebrovascular events and the clinical outcomes, during hospitalization for community-acquired pneumonia (CAP).
  
  
  METHODS
  We performed a retrospective study of 4408 patients with CAP presenting to five hospitals over a 2-year period. Clinical information, co-morbidities, cardiovascular events and 90-day mortality were collected from review of medical case notes. The relationship between cardiovascular events and outcomes were analysed using multivariable logistic regression.
  
  
  RESULTS
  From a total of 4408 patients, 2.2% developed stroke, 5% acute coronary syndrome or myocardial infarction and 9.3% new onset atrial fibrillation. These were associated with increased 90-day mortality [odds ratio (OR), 1.49 95% CI 1.18-1.87, P=0.0006]. Vascular events were independently associated with increased length of hospital stay-median 12 days (IQR 5-22), compared to patients with no vascular events 8 days (IQR 3-17 days, P<0.0001).
  
  
  CONCLUSIONS
  Cardiovascular and cerebrovascular events are common during hospitalization for CAP and are associated with increased 90-day mortality.
authors.affiliation: Department of Respiratory Medicine, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA, UK. pallavimandal@googlemail.com
authors.forename: P
authors.initials: P
authors.lastname: Mandal
authors.forename: J D
authors.initials: JD
authors.lastname: Chalmers
authors.forename: G
authors.initials: G
authors.lastname: Choudhury
authors.forename: A R
authors.initials: AR
authors.lastname: Akram
authors.forename: A T
authors.initials: AT
authors.lastname: Hill
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000209:etiology*; D017714:Community-Acquired Infections / Q000150:complications; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011014:Pneumonia / Q000150:complications* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors