Background Patients with heart failure (HF) are at an increased risk of developing pneumonia, leading to a high mortality. A decrease in muscle strength due to aging or concomitant disease may contribute to the development of pneumonia in older adults. We sought to investigate the relationship between low muscle strength and pneumonia incidence in older patients hospitalized for worsening HF. Methods We carried out a sub-analysis of the FRAGILE-HF, a prospective multicenter observational study, including 1266 consecutive older (≥65 years) patients hospitalized with HF (mean age 80.2±7.8 years; 57.4% male; left ventricular ejection fraction 46±17%) and information of incident pneumonia observed after discharge. Patients were followed up for two years post-discharge. Results A total of 88 patients (7.0%) developed pneumonia after discharge, with an incidence of 42.7 per 1,000 person-years. A total of 893 patients with low muscle strength, defined as handgrip strength <28 kg for men and <18 kg for women according to international criteria, were more likely to develop pneumonia than those with normal muscle strength (p <0.001; log-rank test). Low muscle strength was a significant predictor of incident pneumonia (adjusted hazard ratio with 95% confidence interval: 2.65 [1.31-5.35], p=0.007). Furthermore, the mortality rates were 43.2% in patients who developed pneumonia and 19.3% in those who did not, indicating a heightened risk of death following the onset of pneumonia (adjusted hazard ratio: 4.25 [2.91-6.19], p<0.001). Conclusions In older patients hospitalized for HF, low muscle strength was associated with incident pneumonia after discharge.

中文翻译：

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老年心力衰竭患者肌力不足与肺炎的相关性


背景 心力衰竭 （HF） 患者患肺炎的风险增加，导致高死亡率。由于衰老或伴随疾病而导致的肌肉力量下降可能导致老年人肺炎的发展。我们试图调查因 HF 恶化住院的老年患者肌肉力量不足与肺炎发病率之间的关系。方法 我们对 BRAGILE-HF 进行了亚分析，这是一项前瞻性多中心观察研究，包括连续 1266 例老年 （≥65 岁） 因 HF 住院的患者 （平均年龄 80.2±7.8 岁;57.4% 男性;左心室射血分数 46±17%）和出院后观察到的新发肺炎信息。患者出院后随访两年。结果 88 例 （7.0%） 患者出院后发生肺炎，发病率为 42.7/1000 人年。共有 893 名肌力低的患者，根据国际标准定义为男性握力 <28 kg，女性 <18 kg，比肌肉力量正常的患者更容易患肺炎（p <0.001;log-rank 检验）。低肌肉力量是肺炎新发的重要预测因子 （校正风险比与 95% 置信区间： 2.65 [1.31-5.35]，p=0.007）。此外，发生肺炎的患者死亡率为 43.2%，未发生肺炎的患者死亡率为 19.3%，表明肺炎发作后死亡风险增加（调整后的风险比：4.25 [2.91-6.19]，p<0.001）。结论 在 HF 住院的老年患者中，低肌力与出院后发生肺炎相关。