Gender differences in incidence and in‐hospital outcomes of community‐acquired, ventilator‐associated and nonventilator hospital‐acquired pneumonia in Spain

Abstract

Aims We aim to compare the incidence and in‐hospital outcomes of community‐acquired pneumonia (CAP), ventilator‐associated pneumonia (VAP) and nonventilator hospital‐acquired pneumonia (NV‐HAP) according to gender. Methods This was a retrospective observational epidemiological study using the Spanish National Hospital Discharge Database for the years 2016 and 2017. Results Of 277 785 hospital admissions, CAP was identified in 257 455 (41.04% females), VAP was identified in 3261 (30.42% females) and NV‐HAP was identified in 17 069 (36.58% females). The incidence of all types of pneumonia was higher amongst males (CAP: incidence rate ratio [IRR] 1.05, 95% CI 1.03‐1.06; VAP: IRR 1.36, 95% CI 1.26‐1.46; and NV‐HAP: IRR 1.16, 95% CI 1.14‐1.18). The crude in‐hospital mortality (IHM) rate for CAP was 11.44% in females and 11.80% in males (P = .005); for VAP IHM, the rate was approximately 35% in patients of both genders and for NV‐HAP IHM, the rate was 23.97% for females and 26.40% for males (P < .001). After multivariable adjustment, in patients of both genders, older age and comorbidities were factors associated with IHM in the three types of pneumonia analysed. Female gender was a risk factor for IHM after VAP (OR 1.24; 95% CI 1.06‐1.44), and no gender differences were found for CAP or NV‐HAP. Conclusions Our findings show a difference between females and males, with females presenting a lower incidence of all types of pneumonia. However, female gender was a risk factor for IHM after VAP.

Sex-Related Disparities in the Incidence and Outcomes of Community-Acquired Pneumonia among Type 2 Diabetes Patients: A Propensity Score-Matching Analysis Using the Spanish National Hospital Discharge Database for the Period 2016–2019

“…The strength of our findings lies in the large sample size with data from over 520,723 episodes of CAP (26.96% with T2DM), the widespread coverage of the population of an entire country (> 95% of all hospital admissions), the standardized methodology (which has been extensively used for research in Spain [2,3,7,10,30]), and the reliability of diabetes and CAP coding in the RAE-CMBD [44]. Nevertheless, we should point out several limitations.…”

“…People with type 2 diabetes mellitus (T2DM) are at greater risk of infections, showing worse infection outcomes than those without diabetes [1]. Community-acquired pneumonia (CAP) is an infection that shows an increase in incidence over time and is highly influenced by age and comorbidities [2,3]. CAP often requires hospital admission, especially among older adults [4,5].…”

Incidence, Outcomes and Sex-Related Disparities in Pneumonia: A Matched-Pair Analysis with Data from Spanish Hospitals (2016–2019)

“…We have used a similar methodology in previous research [ 13 , 15 ]. People older than 19 years admitted to the hospital for either CAP or who developed HAP during admission for another condition were included in the study.…”

“…Our group has previously studied the influence of sex on both CAP and the two subtypes of HAP, namely VAP and NV-HAP [ 13 ]. However, the results of this work were somewhat limited by the short time period evaluated (2016–2017).…”

Risk Factors for Mortality in Children with Hospital-Acquired Pneumonia in Dr. Soetomo General Hospital Surabaya

“…López-de-Andrés, et al (2020) in their study also said that being female did not have association with mortality in CAP and HAP, but it did in patients with Ventilator-Associated Pneumonia (VAP). 16 In CAP, there could be other factors correlated with gender which might result in the association with incidence and mortality, adult males tend to smoke more and develop respiratory disease. 17 HAP was found mostly in children under 5 years old, about 74% of all patients in this study.…”