دانلود گزارش کارورزی و کار آموزی

چکیده :

BACKGROUND: Recent studies suggest that there is an increase in cardiovascular disease after pneumonia;

however, there is little information on cardiac arrhythmias after pneumonia. The aims of this study were to

assess the incidence of, and examine risk factors for, cardiac arrhythmias after hospitalization for pneumonia.

METHODS: We conducted a national cohort study using Department of Veterans Affairs administrative data

including patients aged 65 years hospitalized with pneumonia in fiscal years 2002-2007, receiving

antibiotics within 48 hours of admission, having no prior diagnosis of a cardiac arrhythmia, and having at

least 1 year of Veterans Affairs care. We included only the first pneumonia-related hospitalization, and

follow-up was for the 90 days after admission. Cardiac arrhythmias included atrial fibrillation, ventricular

tachycardia/fibrillation, cardiac arrest, and symptomatic bradycardia. We used a multilevel regression

model, adjusting for hospital of admission, to examine risk factors for cardiac arrhythmias.

RESULTS: We identified 32,689 patients who met the inclusion criteria. Of these, 3919 (12%) had a new

diagnosis of cardiac arrhythmia within 90 days of admission. Variables significantly associated with increased

risk of cardiac arrhythmia included increasing age, history of congestive heart failure, and a need for mechanical

ventilation or vasopressors. Beta-blocker use was associated with a decreased incidence of events.

CONCLUSION: An important number of patients have new cardiac arrhythmia during and after hospitalization

for pneumonia. Additional research is needed to determine whether use of cardioprotective

medications will improve outcomes for patients hospitalized with pneumonia. At-risk patients hospitalized

with pneumonia should be monitored for cardiac arrhythmias during the hospitalization.