Study of community-acquired pneumonia: Incidence, patterns of care, and outcomes in primary and hospital care

Capelastegui, Alberto; España, Pedro Pablo; Bilbao, Amaia; Gamazo, Julio; Medel, Federico; Salgado, Juan Carlos; Gorostiaga, Iñaki; Esteban, Cristóbal; Altube, Lander; Gorordo, Inmaculada; Quintana, José M.

doi:10.1016/j.jinf.2010.07.015

Cited by 30 publications

(25 citation statements)

References 33 publications

(29 reference statements)

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“…This ratio was lower (3.3-times) in our study where the adjusted mean total cost was €698.6 per-outpatient and €2,332.4 per-inpatient. However, costs in the present study were higher than those in previous studies focused on direct hospital costs, both in our country (€1,210 [49], and €1,847 [50]), Germany (€1,201) [51] or Italy (€1,587) [52]. Higher costs in our country are probably related with the more recent study period, the higher rate of readmissions, and mainly with the higher number of analyzed variables, including lost of working days.…”

Section: Discussioncontrasting

confidence: 81%

Retrospective epidemiological study for the characterization of community- acquired pneumonia and pneumococcal pneumonia in adults in a well-defined area of Badalona (Barcelona, Spain)

et al. 2012

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BackgroundCommunity-acquired pneumonia (CAP) has large impact on direct healthcare costs, especially those derived from hospitalization. This study determines impact, clinical characteristics, outcome and economic consequences of CAP in the adult (≥18 years) population attended in 6 primary-care centers and 2 hospitals in Badalona (Spain) over a two-year period.MethodsMedical records were identified by codes from the International Classification of Diseases in databases (January 1st 2008-December 31st 2009).ResultsA total of 581 patients with CAP (55.6% males, mean age 57.5 years) were identified. Prevalence: 0.64% (95% CI: 0.5%-0.7%); annual incidence: 3.0 cases/1,000 inhabitants (95% CI: 0.2-0.5). Up to 241 (41.5%) required hospitalization. Hospital admission was associated (p<0.002) with liver disease (OR=5.9), stroke (OR=3.6), dementia (OR=3.5), COPD (OR=2.9), diabetes mellitus (OR=1.9) and age (OR=1.1 per year). Length of stay (4.4±0.3 days) was associated with PSI score (β=0.195), in turn associated with age (r=0.827) and Charlson index (r=0.497). Microbiological tests were performed in all inpatients but only in 35% outpatients. Among patients with microbiological tests, results were positive in 51.7%, and among them, S pneumoniae was identified in 57.5% cases. Time to recovery was 29.9±17.2 days. Up to 7.5% inpatients presented complications, 0.8% required ICU admission and 19.1% readmission. Inhospital mortality rate was 2.5%. Adjusted mean total cost was €2,332.4/inpatient and €698.6/outpatient (p<0.001). Patients with pneumococcal CAP (n=107) showed higher comorbidity and hospitalization (76.6%), higher PSI score, larger time to recovery and higher overall costs among inpatients.ConclusionsStrategies preventing CAP, thus reducing hospital admissions could likely produce substantial costs savings in addition to the reduction of CAP burden.

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Section: Discussioncontrasting

confidence: 81%

Retrospective epidemiological study for the characterization of community- acquired pneumonia and pneumococcal pneumonia in adults in a well-defined area of Badalona (Barcelona, Spain)

et al. 2012

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“…La incidencia de la neumonía adquirida en la comunidad (NAC) se incrementa con la edad, alcanzando de 25 a 35 casos por 1.000 habitantes/año en la población mayor de 65 años. Se asocia a una elevada morbimortalidad y es una causa frecuente de atención urgente e ingreso hospitalario [1][2][3] . La elevada incidencia de la NAC en la población anciana se ha relacionado con una serie de cambios fisiológicos, asociados al envejecimiento, en el aparato respiratorio (disminución del reflejo tusígeno y del aclaramiento mucociliar) e inmunitario (tanto innato como adaptativo), junto con la mayor probabilidad de situaciones clínicas y sociales (edentulismo, disfagia, desnutrición, institucionalización) y de enfermedades crónicas que van siendo acumulativas con la edad (diabetes mellitus, enfermedad pulmonar obstructiva crónica, insuficiencia cardiaca crónica, cáncer e insuficiencia renal crónica) que convierten al anciano en un sujeto más vulnerable al desarrollo de infecciones, y más específicamente de la neumonía, así como de riesgo incrementado a un peor resultado de las mismas [4][5][6] .…”

Section: Introductionunclassified

Guía de consenso para el abordaje de la neumonía adquirida en la comunidad en el paciente anciano

Castillo

Martín‐Sánchez

Llinares

et al. 2014

Revista Española de Geriatría y Gerontología

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The incidence of community-acquired pneumonia increases with age and is associated with an elevated morbidity and mortality due to the physiological changes associated with aging and a greater presence of chronic disease. Taking into account the importance of this disease from an epidemiological and prognostic point of view, and the enormous heterogeneity described in the clinical management of the elderly, we believe a specific consensus document regarding this patient profile is necessary. The purpose of the present work was to perform a review of the evidence related to the risk factors for the etiology, the clinical presentation, the management and the treatment of community-acquired pneumonia in elderly patients with the aim of producing a series of specific recommendations based on critical analysis of the literature. This document is the result of the collaboration of different specialists representing the Spanish Society of Emergency Medicine and Emergency Care (SEMES), the Spanish Society of Geriatrics and Gerontology (SEGG), the Spanish Society of Chemotherapy (SEQ), the Spanish Society of Internal Medicine (SEMI), the Spanish Society of Respiratory Medicine and Thoracic Surgery (SEPAR), Spanish Society of Home Hospitalization (SEHAD) and the Spanish Society of Infectious Disease and Clinical Microbiology (SEIMC).

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“…Community-acquired pneumonia (CAP) has an incidence rate of around 1 case per 1000 population per year in the EU [1] and is associated with considerable morbidity and mortality worldwide, with up to 68.8% of patients requiring hospitalization [1-4]. Previous studies show that patient outcomes are influenced by a number of factors, of which the decision to hospitalize and rapidity of initiation of antibiotic treatment are most important.…”

Section: Introductionmentioning

confidence: 99%

Current management of patients hospitalized with community-acquired pneumonia across Europe: outcomes from REACH

Blasi¹,

Garau²,

Medina³

et al. 2013

Respir Res

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BackgroundData describing real-life management and treatment of community-acquired pneumonia (CAP) in Europe are limited. REACH (http://NCT01293435) was a retrospective, observational study collecting data on the management of EU patients hospitalized with CAP.The purpose of this study was to understand patient and disease characteristics in patients hospitalized with CAP and to review current clinical practices and outcomes.MethodsPatients were aged ≥18 years, hospitalized with CAP between March 2010 and February 2011, and requiring in-hospital treatment with intravenous antibiotics. An electronic Case Report Form was used to collect patient, disease and treatment variables, including type of CAP, medical history, treatment setting, antibiotics administered and clinical outcomes.ResultsPatients (N = 2,039) were recruited from 128 centres in ten EU countries (Belgium, France, Germany, Greece, Italy, the Netherlands, Portugal, Spain, Turkey, UK). The majority of patients were aged ≥65 years (56.4%) and had CAP only (78.8%). Initial antibiotic treatment modification occurred in 28.9% of patients and was more likely in certain groups (patients with comorbidities; more severely ill patients; patients with healthcare-associated pneumonia, immunosuppression or recurrent episodes of CAP). Streamlining (de-escalation) of therapy occurred in 5.1% of patients. Mean length of hospital stay was 12.6 days and overall mortality was 7.2%.ConclusionThese data provide a current overview of clinical practice in patients with CAP in EU hospitals, revealing high rates of initial antibiotic treatment modification. The findings may precipitate reassessment of optimal management regimens for hospitalized CAP patients.

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Study of community-acquired pneumonia: Incidence, patterns of care, and outcomes in primary and hospital care

Cited by 30 publications

References 33 publications

Retrospective epidemiological study for the characterization of community- acquired pneumonia and pneumococcal pneumonia in adults in a well-defined area of Badalona (Barcelona, Spain)

Retrospective epidemiological study for the characterization of community- acquired pneumonia and pneumococcal pneumonia in adults in a well-defined area of Badalona (Barcelona, Spain)

Guía de consenso para el abordaje de la neumonía adquirida en la comunidad en el paciente anciano

Current management of patients hospitalized with community-acquired pneumonia across Europe: outcomes from REACH

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