Increased Risk of Hospitalization for Pneumonia in Italian Adults from 2010 to 2019: Scientific Evidence for a Call to Action

Abstract

Background: Understanding trends in pneumonia-associated hospitalizations can help to quantify the burden of disease and identify risk conditions and at-risk populations. This study evaluated characteristics of hospitalizations due to pneumonia that occurred in Italy in a 10-year period from 2010 to 2019. Methods: All hospitalizations with a principal or secondary diagnosis of pneumonia over the 10-year period were included, which were identified by hospital discharges for all-cause pneumonia and pneumococcal pneumonia in the anonymized hospital discharge database of the Italian Health Ministry. Results: A total of 2,481,213 patients were hospitalized for pneumonia between 2010 and 2019; patients aged 75–86 years accounted for 30.1% of hospitalizations. Most hospitalizations (88.1%) had an unspecified pneumonia discharge code. In-hospital death was recorded in 13.0% of cases. The cumulative cost for pneumonia hospitalizations of the 10-year period were EUR 11,303,461,591. Over the observation period, the incidence rate for hospitalized all-cause pneumonia in any ages increased from 100 per 100,000 in 2010 to over 160 cases per 100,000 per year in 2019 (p < 0.001). Overall, there was a significant increase in annual percent changes in hospitalization rates (+3.47 per year), in-hospital death (+4.6% per year), and costs (+3.95% per year) over the 10-year period. Conclusions: Our analysis suggests that hospitalizations for pneumonia are increasing over time in almost all age groups, especially in the elderly. Given the substantial burden of pneumonia in terms of mortality, healthcare resources, and economic costs, greater public health efforts should thus be made to promote vaccinations against influenza and pneumococcus, particularly in high-risk groups.

The Burden of Streptococcus pneumoniae-Related Admissions and In-Hospital Mortality: A Retrospective Observational Study between the Years 2015 and 2022 from a Southern Italian Province

“…HDRs represent a very important source for invasive Streptococcus pneumoniae disease and for the evaluation of data concerning hospitalizations, comorbidities, and deaths. The study of HDRs has already been used as an indirect source of data to measure both the effectiveness of vaccination strategies [ 23 , 24 , 25 ] and to guide them [ 26 , 27 , 28 ].…”

Hospital Burden of All-Cause Pneumonia and Nonbacteremic Pneumococcal Pneumonia in Adults in France Between 2013 and 2019

“…Several European studies conducted over a similar period provide context for our results. In an Italian study conducted from the hospital discharge database of the Italian Health Ministry, the incidence rate of all-cause pneumonia was estimated as 496/100K in 2019 [ 25 ]. However, a higher incidence was reported in Germany in a study conducted on representative healthcare claims database [ 26 ] (1054 per 100K adult population in 2015 vs 608/100K in the current study).…”

Epidemiology and burden of respiratory syncytial virus in Italian adults: A systematic review and meta-analysis

“…Cai et al [ 24 ] have documented that the RSV-specific ICD-10 codes had a very low sensitivity of 6%. Retrospective cohort studies based on HDRs only (i.e., without matching with laboratory data) would identify an implausibly low number of RSV-specific diagnostic codes [ 35 , 74 ]. Another important data gap concerns RSV epidemiology and BoD in residents of long-term care facilities, who may be the primary target population for vaccination.…”