PURPOSE: Recent studies suggest that there is an increase in cardiovascular disease after pneumonia however there is little information on incidence of a new diagnosis of cardiac arrhythmia after pneumonia. The aims of this study were to assess the incidence of a new diagnosis of cardiac arrhythmia during or after hospitalization for pneumonia in a population-based database.
METHODS: We conducted a national cohort study using United States Department of Veterans Affairs (VA) administrative data including patients >65 years hospitalized with a discharge ICD-9 diagnosis of pneumonia in fiscal years 2002-2007, receiving antibiotics within 48 hours of admission, who did not have a prior diagnosis of a cardiac arrhythmia, and having at least one year of VA outpatient care. We included only the first pneumonia-related hospitalization during the time period, and follow-up was for the 90 days after the date of 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 new diagnosis of arrhythmia.
RESULTS: We identified 50,119 patients who were hospitalized with pneumonia during the study period, and of these, 17,340 (34.8%) patients had a prior diagnosis of arrhythmia and were excluded from further analyses. During the index hospitalization 2,103 (6.4%) had a new diagnosis of cardiac arrhythmia, and an additional 996 (3.0%) were diagnosed after discharge but within 90-days of admission. Variables significantly associated with increased risk of cardiac arrhythmia included increasing age, ICU admission, and history of congestive heart failure.
CONCLUSION: A clinically important number of patients have new cardiac arrhythmia during and post-hospitalization for pneumonia. Additional research is needed to determine if use of cardioprotective medications will improve outcomes for patients hospitalized with pneumonia.
CLINICAL IMPLICATIONS: At risk patients 65 years of age and older hospitalized with pneumonia should be monitored for cardiac arrhythmias during the hospitalization.
DISCLOSURE: Eric Mortensen, No Financial Disclosure Information; No Product/Research Disclosure Information