Role of Pneumonia in Lethal Outcomes in Patients with Myocardial Infarction and Stroke
Study Objective: To assess the role of pneumonia in lethal outcomes in patients with myocardial infarction and stroke.
Study Design: This was a retrospective analysis.
Materials and Methods: We reviewed archive data of 140 autopsy reports and case histories of patients who died of cardiovascular accidents. These were patients who had been treated at Prof. Ostroumov City Clinical Hospital No. 33, Moscow.
Results and Discussion: Pneumonia diagnosed during hospital treatment was documented in 79 (56.4%) patients and was reported in 123 (87.9%) cases referred for autopsy. Pathological signs of pneumonia were found in 75 (53.6%) of cases and pneumonia was recorded as the main cause of death in 21 (15.0%) of autopsy reports. Pneumonia developed in 65 (67.7 ± 4.8%) patients with ischemic stroke and 24 (23 ± 4.4%) patients with hemorrhagic stroke. Patients without pneumonia statistically more often had myocardial infarction as their main clinical diagnosis. In patients with stroke and myocardial infarction, age, pyrexia, leukocytosis, auscultatory evidence of cerebrovascular accident, and a confirmed diagnosis of cerebrovascular accident are significant predictors of pneumonia.
Conclusion: This study confirmed that pneumonia is commonly developed in patients with cardiovascular accidents and plays a certain role in the lethal outcome. A timely diagnosis and creation of treatment and management guidelines for this patient population would improve their survival and prognosis. Further studies are needed to investigate the prevalence of pneumonia and its role in lethal outcomes.
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Igor Evgenievich Khatkov, Head of A. S. Loginov Moscow Clinical Scientific and Practical Centre, Chief Oncologist in and for Moscow is now an honoured member of the American Surgical Association.