Retrospective study on cardiovascular risks and prognosis in elderly patients with community-acquired pneumonia

Elderly patients with community-acquired pneumonia (CAP) are a common infectious disease group, particularly with a high incidence in the elderly population. With the aging of society, the management of elderly CAP patients faces greater challenges. Elderly CAP patients are often accompanied by cardiovascular diseases, and the incidence of secondary cardiovascular events is high, severely affecting their clinical prognosis. Therefore, identifying risk factors for secondary cardiovascular events and exploring their impact on patient prognosis is of great significance for improving treatment outcomes. This study retrospectively analyzed 110 elderly CAP patients admitted from January 2023 to January 2024, divided into an event group (n = 45) and a non-event group (n = 65) based on the occurrence of secondary cardiovascular events. Basic clinical data were collected, and the relationship between advanced age, smoking history, hypertension, diabetes, and inflammatory markers (C-reactive protein and neutrophil/lymphocyte ratio) and secondary cardiovascular events was analyzed. Univariate and multivariate logistic regression analyses were used to assess the impact of various factors on cardiovascular events, and a 12-month follow-up was conducted to evaluate their effect on clinical prognosis. The event group had significantly higher average age, smoking history, and incidence of hypertension and diabetes than the non-event group. The incidence of secondary cardiovascular events was 40.9%, with heart failure accounting for 42.2%, acute myocardial infarction for 26.7%, and arrhythmia for 31.1%. Advanced age (odds ratio [OR] = 1.45, 95% confidence interval [CI]: 1.12-1.88), hypertension (OR = 1.76, 95% CI: 1.21-2.57), and diabetes (OR = 1.69, 95% CI: 1.14-2.48) were independent risk factors for secondary cardiovascular events. The levels of C-reactive protein and neutrophil/lymphocyte ratio were significantly higher in the event group compared to the non-event group (P < .05). The all-cause mortality rate for the secondary cardiovascular event group was 24.4%, and the readmission rate was 37.8%, significantly higher than that of the non-event group (P < .05). The area under the curve of the multivariate regression model was 0.82, indicating good predictive ability. Advanced age, smoking history, hypertension, diabetes, and inflammatory responses are independent risk factors for secondary cardiovascular events in elderly CAP patients, and secondary cardiovascular events significantly impact clinical prognosis. Clinical efforts should focus on identifying and intervening in high-risk factors to reduce the occurrence of secondary cardiovascular events.