Australian Institute of Tropical Health and Medicine, James Cook University, 1 James Cook Drive, Douglas, QLD, 4814, Australia.
College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Douglas, QLD, 4814, Australia.
Sci Rep. 2021 Mar 25;11(1):6826. doi: 10.1038/s41598-021-86301-3.
Acute respiratory infections appear to precipitate vascular events. Acute myocardial infarction (AMI) and stroke are the leading cause of death and disability globally. This study was based on a cohort of patients admitted to Townsville University Hospital between January 2006 and December 2016. Using a self-controlled case series design, we investigated the risk of AMI or ischaemic stroke after an episode of pneumonia. We defined the 'risk interval' as the first 14 days after hospitalisation for pneumonia and the 'control interval' as one year before and one year after the risk interval. Among a population (N = 4557) with a median age of over 70, a total of 128 AMI and 27 stroke cases were identified within 1 year of an episode of pneumonia in this study. Ten and two admissions occurred during the risk interval, while 118 and 25 admissions occurred during the control period. The relative incidence ratios (RIR) of AMI increased after an episode of pneumonia (RIR=4.85, 95% confidence interval (CI) 2.44-9.67). The risk for stroke after the exposure period of 14 days was 4.94 (95% CI 1.12-21.78) considering only the first stroke incidence. The RIR results for AMI and stroke were not altered by adjusting for age, sex or Indigenous status. The risk of AMI and stroke were significantly higher two weeks after an episode of pneumonia.
急性呼吸道感染似乎会引发血管事件。急性心肌梗死(AMI)和中风是全球范围内导致死亡和残疾的主要原因。本研究基于 2006 年 1 月至 2016 年 12 月期间入住汤斯维尔大学医院的患者队列。我们采用自身对照病例系列设计,研究了肺炎发作后发生 AMI 或缺血性中风的风险。我们将“风险间隔”定义为肺炎住院后的前 14 天,将“对照间隔”定义为风险间隔前一年和后一年。在一个中位数年龄超过 70 岁的人群(N=4557)中,本研究在肺炎发作后一年内共发现 128 例 AMI 和 27 例中风病例。在风险间隔期间发生了 10 次和 2 次住院,而在对照期间发生了 118 次和 25 次住院。肺炎发作后 AMI 的相对发病率比(RIR)增加(RIR=4.85,95%置信区间[CI] 2.44-9.67)。仅考虑首次中风发生率,肺炎暴露后 14 天发生中风的风险为 4.94(95%CI 1.12-21.78)。调整年龄、性别或原住民身份后,AMI 和中风的 RIR 结果没有改变。肺炎发作后两周,AMI 和中风的风险明显升高。