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- Title
The impact of pre-existing heart failure on pneumonia prognosis: population-based cohort study.
- Authors
Thomsen, Reimar; Kasatpibal, Nongyao; Riis, Anders; Nørgaard, Mette; Sørensen, Henrik; Thomsen, Reimar W; Nørgaard, Mette; Sørensen, Henrik T
- Abstract
<bold>Background: </bold>There are limited data describing how pre-existing heart failure affects mortality following pneumonia.<bold>Objective: </bold>To examine the association between history and severity of heart failure and mortality among patients hospitalized for pneumonia.<bold>Design: </bold>Population-based cohort study in Western Denmark between 1994 and 2003.<bold>Patients: </bold>33,736 adults with a first-time hospitalization for pneumonia. Heart failure was identified and categorized based on data linked from population-based health care databases.<bold>Measurements: </bold>We compared 30-day mortality between patients with pre-existing heart failure and other pneumonia patients, while adjusting for age, gender, comorbidity, and medication use.<bold>Results: </bold>The 30-day mortality was 24.4% among heart-failure patients and 14.4% among other patients, with an adjusted 30-day mortality rate ratio (MRR) of 1.40 (95% CI: 1.29-1.51). Adjusted MRRs increased according to severity of pre-existing heart failure, as indicated by medication regimen: thiazide-based, MRR = 1.09 (95% CI: 0.79-1.50); loop-diuretics, MRR = 1.25 (95% CI: 1.10-1.43); loop-diuretics and digoxin, MRR = 1.35 (95% CI: 1.18-1.55); loop-diuretics and spironolactone, MRR = 1.72 (95% CI: 1.49-2.00). Pre-existing heart valve disease and atrial fibrillation substantially increased mortality.<bold>Conclusion: </bold>History and severity of heart failure are associated with a poor outcome for patients hospitalized with pneumonia.
- Subjects
HEART failure; HEART diseases; PNEUMONIA; HOSPITAL patients; MORTALITY; DRUG efficacy
- Publication
JGIM: Journal of General Internal Medicine, 2008, Vol 23, Issue 9, p1407
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-008-0672-3