Pneumonia: An arrhythmogenic disease?

Natalia Soto-Gomez, Antonio R Anzueto, Grant W. Waterer, Marcos Restrepo, Eric M. Mortensen

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Recent studies suggest that there is an increase in cardiovascular disease after pneumonia; however, there is little information on cardiac arrhythmias after pneumonia. The aims of this study were to assess the incidence of, and examine risk factors for, cardiac arrhythmias after hospitalization for pneumonia. Methods: We conducted a national cohort study using Department of Veterans Affairs administrative data including patients aged ≥65 years hospitalized with pneumonia in fiscal years 2002-2007, receiving antibiotics within 48 hours of admission, having no prior diagnosis of a cardiac arrhythmia, and having at least 1 year of Veterans Affairs care. We included only the first pneumonia-related hospitalization, and follow-up was for the 90 days after admission. Cardiac arrhythmias included atrial fibrillation, ventricular tachycardia/fibrillation, cardiac arrest, and symptomatic bradycardia. We used a multilevel regression model, adjusting for hospital of admission, to examine risk factors for cardiac arrhythmias. Results: We identified 32,689 patients who met the inclusion criteria. Of these, 3919 (12%) had a new diagnosis of cardiac arrhythmia within 90 days of admission. Variables significantly associated with increased risk of cardiac arrhythmia included increasing age, history of congestive heart failure, and a need for mechanical ventilation or vasopressors. Beta-blocker use was associated with a decreased incidence of events. Conclusion: An important number of patients have new cardiac arrhythmia during and after hospitalization for pneumonia. Additional research is needed to determine whether use of cardioprotective medications will improve outcomes for patients hospitalized with pneumonia. At-risk patients hospitalized with pneumonia should be monitored for cardiac arrhythmias during the hospitalization.

Original languageEnglish (US)
Pages (from-to)43-48
Number of pages6
JournalAmerican Journal of Medicine
Volume126
Issue number1
DOIs
StatePublished - Jan 2013

Fingerprint

Cardiac Arrhythmias
Pneumonia
Hospitalization
Veterans
Incidence
Ventricular Fibrillation
Bradycardia
Ventricular Tachycardia
Heart Arrest
Artificial Respiration
Atrial Fibrillation
Cohort Studies
Cardiovascular Diseases
Heart Failure
Anti-Bacterial Agents
Research

Keywords

  • Cardiac arrhythmia
  • Mortality
  • Pneumonia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Pneumonia : An arrhythmogenic disease? / Soto-Gomez, Natalia; Anzueto, Antonio R; Waterer, Grant W.; Restrepo, Marcos; Mortensen, Eric M.

In: American Journal of Medicine, Vol. 126, No. 1, 01.2013, p. 43-48.

Research output: Contribution to journalArticle

Soto-Gomez, Natalia ; Anzueto, Antonio R ; Waterer, Grant W. ; Restrepo, Marcos ; Mortensen, Eric M. / Pneumonia : An arrhythmogenic disease?. In: American Journal of Medicine. 2013 ; Vol. 126, No. 1. pp. 43-48.
@article{1742de19606940e19c0bf334eca62ff3,
title = "Pneumonia: An arrhythmogenic disease?",
abstract = "Background: Recent studies suggest that there is an increase in cardiovascular disease after pneumonia; however, there is little information on cardiac arrhythmias after pneumonia. The aims of this study were to assess the incidence of, and examine risk factors for, cardiac arrhythmias after hospitalization for pneumonia. Methods: We conducted a national cohort study using Department of Veterans Affairs administrative data including patients aged ≥65 years hospitalized with pneumonia in fiscal years 2002-2007, receiving antibiotics within 48 hours of admission, having no prior diagnosis of a cardiac arrhythmia, and having at least 1 year of Veterans Affairs care. We included only the first pneumonia-related hospitalization, and follow-up was for the 90 days after admission. Cardiac arrhythmias included atrial fibrillation, ventricular tachycardia/fibrillation, cardiac arrest, and symptomatic bradycardia. We used a multilevel regression model, adjusting for hospital of admission, to examine risk factors for cardiac arrhythmias. Results: We identified 32,689 patients who met the inclusion criteria. Of these, 3919 (12{\%}) had a new diagnosis of cardiac arrhythmia within 90 days of admission. Variables significantly associated with increased risk of cardiac arrhythmia included increasing age, history of congestive heart failure, and a need for mechanical ventilation or vasopressors. Beta-blocker use was associated with a decreased incidence of events. Conclusion: An important number of patients have new cardiac arrhythmia during and after hospitalization for pneumonia. Additional research is needed to determine whether use of cardioprotective medications will improve outcomes for patients hospitalized with pneumonia. At-risk patients hospitalized with pneumonia should be monitored for cardiac arrhythmias during the hospitalization.",
keywords = "Cardiac arrhythmia, Mortality, Pneumonia",
author = "Natalia Soto-Gomez and Anzueto, {Antonio R} and Waterer, {Grant W.} and Marcos Restrepo and Mortensen, {Eric M.}",
year = "2013",
month = "1",
doi = "10.1016/j.amjmed.2012.08.005",
language = "English (US)",
volume = "126",
pages = "43--48",
journal = "American Journal of Medicine",
issn = "0002-9343",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Pneumonia

T2 - An arrhythmogenic disease?

AU - Soto-Gomez, Natalia

AU - Anzueto, Antonio R

AU - Waterer, Grant W.

AU - Restrepo, Marcos

AU - Mortensen, Eric M.

PY - 2013/1

Y1 - 2013/1

N2 - Background: Recent studies suggest that there is an increase in cardiovascular disease after pneumonia; however, there is little information on cardiac arrhythmias after pneumonia. The aims of this study were to assess the incidence of, and examine risk factors for, cardiac arrhythmias after hospitalization for pneumonia. Methods: We conducted a national cohort study using Department of Veterans Affairs administrative data including patients aged ≥65 years hospitalized with pneumonia in fiscal years 2002-2007, receiving antibiotics within 48 hours of admission, having no prior diagnosis of a cardiac arrhythmia, and having at least 1 year of Veterans Affairs care. We included only the first pneumonia-related hospitalization, and follow-up was for the 90 days after admission. Cardiac arrhythmias included atrial fibrillation, ventricular tachycardia/fibrillation, cardiac arrest, and symptomatic bradycardia. We used a multilevel regression model, adjusting for hospital of admission, to examine risk factors for cardiac arrhythmias. Results: We identified 32,689 patients who met the inclusion criteria. Of these, 3919 (12%) had a new diagnosis of cardiac arrhythmia within 90 days of admission. Variables significantly associated with increased risk of cardiac arrhythmia included increasing age, history of congestive heart failure, and a need for mechanical ventilation or vasopressors. Beta-blocker use was associated with a decreased incidence of events. Conclusion: An important number of patients have new cardiac arrhythmia during and after hospitalization for pneumonia. Additional research is needed to determine whether use of cardioprotective medications will improve outcomes for patients hospitalized with pneumonia. At-risk patients hospitalized with pneumonia should be monitored for cardiac arrhythmias during the hospitalization.

AB - Background: Recent studies suggest that there is an increase in cardiovascular disease after pneumonia; however, there is little information on cardiac arrhythmias after pneumonia. The aims of this study were to assess the incidence of, and examine risk factors for, cardiac arrhythmias after hospitalization for pneumonia. Methods: We conducted a national cohort study using Department of Veterans Affairs administrative data including patients aged ≥65 years hospitalized with pneumonia in fiscal years 2002-2007, receiving antibiotics within 48 hours of admission, having no prior diagnosis of a cardiac arrhythmia, and having at least 1 year of Veterans Affairs care. We included only the first pneumonia-related hospitalization, and follow-up was for the 90 days after admission. Cardiac arrhythmias included atrial fibrillation, ventricular tachycardia/fibrillation, cardiac arrest, and symptomatic bradycardia. We used a multilevel regression model, adjusting for hospital of admission, to examine risk factors for cardiac arrhythmias. Results: We identified 32,689 patients who met the inclusion criteria. Of these, 3919 (12%) had a new diagnosis of cardiac arrhythmia within 90 days of admission. Variables significantly associated with increased risk of cardiac arrhythmia included increasing age, history of congestive heart failure, and a need for mechanical ventilation or vasopressors. Beta-blocker use was associated with a decreased incidence of events. Conclusion: An important number of patients have new cardiac arrhythmia during and after hospitalization for pneumonia. Additional research is needed to determine whether use of cardioprotective medications will improve outcomes for patients hospitalized with pneumonia. At-risk patients hospitalized with pneumonia should be monitored for cardiac arrhythmias during the hospitalization.

KW - Cardiac arrhythmia

KW - Mortality

KW - Pneumonia

UR - http://www.scopus.com/inward/record.url?scp=84871621916&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84871621916&partnerID=8YFLogxK

U2 - 10.1016/j.amjmed.2012.08.005

DO - 10.1016/j.amjmed.2012.08.005

M3 - Article

C2 - 23177550

AN - SCOPUS:84871621916

VL - 126

SP - 43

EP - 48

JO - American Journal of Medicine

JF - American Journal of Medicine

SN - 0002-9343

IS - 1

ER -