Atrial Fibrillation Is an Independent Risk Factor for Hospital-Acquired Pneumonia
Open Access
- 23 July 2015
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 10 (7), e0131782
- https://doi.org/10.1371/journal.pone.0131782
Abstract
Patients who were hospitalized for community-based pneumonia frequently had pre-existing atrial fibrillation (AF) and had subsequent cardiovascular complications. Whether patients who had AF would be susceptible to the development of hospital-acquired pneumonia (HAP) is a serious concern but this has not been investigated. In our clinics, we have made empirical observation of such susceptibility. To investigate the association between newly developed HAP and pre-existing AF, and to identify whether AF is an independent risk factor for HAP. Hospital data from 8657 sequentially admitted inpatients [1059 patients with AF and 7598 without AF (NAF)] were collected from the Department of Cardiology, First Affiliated Hospital of Shantou University Medical College, Shantou, China, from January 1, 2009 to December 31, 2011. Exclusion criteria were: having previous or current pneumonia, pacemakers, sick sinus syndrome and repeated hospitalization. The incidence of HAP (within 48 hours after hospitalization) was identified among all the patients. Among the AF patients, 274 had HAP (adjusted rate 25.64%) which was significantly higher than the 276 NAF patients who had HAP (adjusted rate 3.66%; P<0.001). The increased risk was also associated with high blood pressure, heart failure and age, but not with gender, smoking, coronary heart disease, diabetes, congenital heart disease. In addition, our multiple regression analysis indicates that AF is an independent risk factor for HAP. We have identified, for the first time, that AF is an important risk factor for HAP. Although additional clinical confirmation is needed, our data provide valuable evidence for use in prevention of HAP which is the most common cause of death from nosocomial infection.This publication has 22 references indexed in Scilit:
- Risk factors for the development of pneumonia post cardiac surgeryCardioVascular Journal of Africa, 2012
- Frequent Early Cardiac Complications Contribute to Worse Stroke Outcome in Atrial FibrillationCerebrovascular Diseases, 2011
- Guidelines for the management of atrial fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC)European Heart Journal, 2010
- Mortality and time to extubation in severe hospital-acquired pneumoniaAmerican Journal of Infection Control, 2009
- Prevention of Atrial FibrillationCirculation, 2009
- Epidemiology, etiology, and diagnosis of hospital-acquired pneumonia and ventilator-associated pneumonia in Asian countriesAmerican Journal of Infection Control, 2008
- ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation–executive summary. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients with Atrial Fibrillation)European Heart Journal, 2007
- ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation–executive summaryEuropean Heart Journal, 2006
- Aspiration Risk After Acute Stroke: Comparison of Clinical Examination and Fiberoptic Endoscopic Evaluation of SwallowingDysphagia, 2002
- Ventilator-associated PneumoniaAmerican Journal of Respiratory and Critical Care Medicine, 2002