Community acquired pneumonia and cardiovascular complications

Abstract

Introduction: Community- acquired pneumonia (CAP) is one of the leading causes of mortality and morbidity, both inside the country and around the world, affecting children, youngsters, adults and the elderly alike. CAP incidence varies throughout the world, 5 to 12 cases being reported per 1000 patients. This number increases significantly in older patients and those debilitated, reaching up to 25-40 in 1000. Cardiovascular complications increase the risk of short-term mortality, reduce the quality of life of these patients and prolong the hospitalization period, hence have as well an economic impact. Purpose and Objectives: To evaluate the particularities of the clinical course and course for treatment in patients with CAP who developed cardiovascular complications. Materials and methods: This is a retrospective study that included 68 patients with confirmed CAP admitted to the Municipal Hospital N3 „Sfînta Treime” during the period of 1.01.2013-1.01.2014. The patients were divided into two groups: group I included patients admitted with CAP that developed cardiovascular complications; group II included patients with CAP alone. All the data was statistically processed in Excel, applying Student T Test and Fisher's exact test for contingency tables. Results: During our study we’ve looked for cardiovascular complications in patients with CAP: new or worsening arrhythmias, new or worsening heart failure, or both. Our study revealed that 17,7% (12/34) o f patients we’ve examined presented with new or worsening arrhythmias, 20,6% (14/34) presented with new or worsening heart failure, and 11,8 %(8/68) presented with both. Following a careful analysis of the acquired data we’ve established there is a statistically significant difference between the two groups considering the average age of the patients (64.74± 12.21 - 1 group, 49,46± 20.58 - II group). Patients form the I group presented more frequently with COPB (50%, 17/34), hypertension (67,7%, 23/34), chest pain (53%, 18/34), heart failure (53%, 18/34). There was a difference in the clinical manifestations of the patients from the two groups. The first group presented with dyspnea in 97% of cases (33/34) vs the second group where dyspnea was reported in 85,3% (29/34). Also patients from the first group presented more frequently with sweating 50% (17/34) vs 35,3% (12/34). It takes longer for the clinical parameters to normalize in patients from the first group. Also the average period of hospitalizations was longer for the patients from the first group (10,1 ± 2,3 days) vs patients from the second group (8,9 ± 2,1 days). Conclusion: Patients with CAP that developed cardiovascular complications present more frequently with comorbidities that are risk factors for the onset of their cardiovascular complications. The clinical course of CAP reveals a jumble of symptoms that vary in intensity and severity. The treatment course of this kind of patients is longer and requires special attention, especially in terms of sodium intake. These patients require longer hospitalization and the frequency of short-term death is higher among them.