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Intermediate and long-term risk of new-onset heart failure after hospitalization for pneumonia in elderly adults.
Friday,2015-08-28 11:23 America/Los_Angeles — zdrager
| Title | Intermediate and long-term risk of new-onset heart failure after hospitalization for pneumonia in elderly adults. |
| Publication Type | Journal Article |
| Year of Publication | 2015 |
| Authors | Corrales-Medina, VF, Taljaard, M, Yende, S, Kronmal, R, Dwivedi, G, Newman, AB, Elkind, MSV, Lyles, MF, Chirinos, JA |
| Journal | Am Heart J |
| Volume | 170 |
| Issue | 2 |
| Pagination | 306-12 |
| Date Published | 2015 Aug |
| ISSN | 1097-6744 |
| Keywords | Aged, Disease Progression, Female, Follow-Up Studies, Forecasting, Heart Failure, Hospitalization, Humans, Incidence, Inpatients, Male, Patient Readmission, Pneumonia, Proportional Hazards Models, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors |
| Abstract | <p><b>BACKGROUND: </b>Pneumonia is associated with high risk of heart failure (HF) in the short term (30 days) postinfection. Whether this association persists beyond this period is unknown.</p><p><b>METHODS: </b>We studied 5,613 elderly (≥65 years) adults enrolled in the Cardiovascular Health Study between 1989 and 1994 at 4 US communities. Participants had no clinical diagnosis of HF at enrollment, and they were followed up through December 2010. Hospitalizations for pneumonia were identified using validated International Classification of Disease Ninth Revision codes. A centralized committee adjudicated new-onset HF events. Using Cox regression, we estimated adjusted hazard ratios (HRs) of new-onset HF at different time intervals after hospitalization for pneumonia.</p><p><b>RESULTS: </b>A total of 652 participants hospitalized for pneumonia during follow-up were still alive and free of clinical diagnosis of HF by day 30 posthospitalization. Relative to the time of their hospitalization, new-onset HF occurred in 22 cases between 31 and 90 days (HR 6.9, 95% CI 4.46-10.63, P < .001), 14 cases between 91 days and 6 months (HR 3.2, 95% CI 1.88-5.50, P < .001), 20 cases between 6 months and 1 year (HR 2.6, 95% CI 1.64-4.04, P < .001), 76 cases between 1 and 5 years (HR 1.7, 95% CI 1.30-2.12, P < .001), and 71 cases after 5 years (HR 2.0, 95% CI 1.56-2.58, P < .001). Results were robust to sensitivity analyses using stringent definitions of pneumonia and extreme assumptions for potential informative censoring.</p><p><b>CONCLUSION: </b>Hospitalization for pneumonia is associated with increased risk of new-onset HF in the intermediate and long term. Studies should characterize the mechanisms of this association in order to prevent HF in elderly pneumonia survivors.</p> |
| DOI | 10.1016/j.ahj.2015.04.028 |
| Alternate Journal | Am. Heart J. |
| PubMed ID | 26299228 |
| PubMed Central ID | PMC4548825 |
| Grant List | AG023629 / AG / NIA NIH HHS / United States HHSN268200800007C / / PHS HHS / United States HHSN268201200036C / / PHS HHS / United States HL080295 / HL / NHLBI NIH HHS / United States K23GM083215 / GM / NIGMS NIH HHS / United States N01 HC55222 / HC / NHLBI NIH HHS / United States N01HC85079 / HC / NHLBI NIH HHS / United States N01HC85080 / HC / NHLBI NIH HHS / United States N01HC85081 / HC / NHLBI NIH HHS / United States N01HC85082 / HC / NHLBI NIH HHS / United States N01HC85083 / HC / NHLBI NIH HHS / United States N01HC85086 / HC / NHLBI NIH HHS / United States R01 HL080295 / HL / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States UL1 TR000005 / TR / NCATS NIH HHS / United States |