Polyakov D S, Fomin I V, Valikulova F Yu, Vaisberg A R, Kraiem N
Nizhny Novgorod State Medical Academy, Ministry of Health of Russia, Nizhny Novgorod, Russia.
Ter Arkh. 2016;88(9):17-22. doi: 10.17116/terarkh201688917-22.
To evaluate the impact of community-acquired pneumonia (CAP) on short-term and long-term prognosis in patients hospitalized with signs of chronic decompensated heart failure (CDHF).
A total of 852 cases were admitted to therapy/cardiology hospital with signs of CDHF during a year.
Among the patients hospitalized with signs of CDHF, the prevalence of CAP was 16.5%. This indicator did not depend on the age of hospitalized patients. Among the multisystem disorders, hypertension, different forms of coronary heart disease, diabetes mellitus, and chronic obstructive pulmonary disease were more common in the patients with CAP. The presence of the latter in a patient with CDHF statistically significantly increased the length of hospital stay (13.1 versus 11.9 days; p = 0.009) and also the probability of rehospitalization during a year (odds ratio (OR) 1.9; p = 0.02). The presence of CAP in a patient with CDHF resulted in an increase in mortality rates (OR 13.5; p < 0.001); moreover, the highest risk of a fatal outcome was noted on day 1 of hospitalization (12.7%). During one-year follow-up, the risk of death in patients hospitalized with CDHF and concomitant pneumonia proved to be higher (OR 4.8; p < 0.001) than in those without pneumonia.
评估社区获得性肺炎（CAP）对因慢性失代偿性心力衰竭（CDHF）体征住院患者短期和长期预后的影响。
一年内共有852例因CDHF体征入住治疗/心脏病医院。
在因CDHF体征住院的患者中，CAP的患病率为16.5%。该指标与住院患者的年龄无关。在多系统疾病中，高血压、不同形式的冠心病、糖尿病和慢性阻塞性肺疾病在CAP患者中更为常见。CDHF患者中存在后者在统计学上显著增加了住院时间（13.1天对11.9天；p = 0.009）以及一年内再次住院的概率（优势比（OR）1.9；p = 0.02）。CDHF患者中存在CAP导致死亡率增加（OR 13.5；p < 0.001）；此外，在住院第1天观察到致命结局的风险最高（12.7%）。在一年的随访中，因CDHF住院且伴有肺炎的患者的死亡风险（OR 4.8；p < 0.001）高于无肺炎的患者。
