dc.contributor.author |
Cillóniz, Catia |
dc.contributor.author |
Liapikou, Adamantia |
dc.contributor.author |
Martin Loeches, Ignacio |
dc.contributor.author |
Garcia Vidal, Carolina |
dc.contributor.author |
Gabarrús, Albert |
dc.contributor.author |
Ceccato, Adrian |
dc.contributor.author |
Magdaleno, Daniel |
dc.contributor.author |
Mensa Pueyo, Josep |
dc.contributor.author |
Marco, Francesc |
dc.contributor.author |
Torres Martí, Antoni |
dc.date |
2019-02-20T15:09:26Z |
dc.date |
2019-02-20T15:09:26Z |
dc.date |
2018-07-18 |
dc.date |
2019-02-14T16:04:53Z |
dc.identifier.citation |
1932-6203 |
dc.identifier.uri |
http://hdl.handle.net/2445/128562 |
dc.format |
16 p. |
dc.format |
application/pdf |
dc.language.iso |
eng |
dc.publisher |
Public Library of Science (PLoS) |
dc.relation |
Reproducció del document publicat a: http://dx.doi.org/10.1371/journal.pone.0200504 |
dc.relation |
PLoS One, 2018, vol. 13, num. 7, p. e0200504 |
dc.relation |
http://dx.doi.org/ 10.1371/journal.pone.0200504 |
dc.rights |
cc by (c) Cillóniz et al, 2018 |
dc.rights |
info:eu-repo/semantics/openAccess |
dc.rights |
http://creativecommons.org/licenses/by/3.0/es/ |
dc.subject |
Pneumònia adquirida a la comunitat |
dc.subject |
Pneumococs |
dc.subject |
Mortalitat |
dc.subject |
Community-acquired pneumonia |
dc.subject |
Streptococcus pneumoniae |
dc.subject |
Mortality |
dc.title |
Twenty-year trend in mortality among hospitalized patients with pneumococcal community-acquired pneumonia |
dc.type |
info:eu-repo/semantics/article |
dc.type |
info:eu-repo/semantics/publishedVersion |
dc.description.abstract |
Background: There is only limited information on mortality over extended periods in hospitalized patients with pneumococcal community-acquired pneumonia (CAP). We aimed to evaluate the 30-day mortality and whether is changed over a 20-year period among immunocompetent adults hospitalized with pneumococcal CAP. Methods: We conducted a retrospective observational study of data that were prospectively collected at the Hospital Clinic of Barcelona of all adult patients hospitalized with diagnosis of pneumococcal CAP over a 20-year period. To aid analysis, results were divided into four periods of 5 years each (1997–2001, 2002–2006, 2007–2011, 2012–2016). The primary outcome was 30-day mortality, but secondary outcomes included intensive care unit (ICU) admission, lengths of hospital and ICU-stays, ICU-mortality, and need of mechanical ventilation. Results: From a cohort of 6,403 patients with CAP, we analyzed the data for 1,120 (17%) adults with a diagnosis of pneumococcal CAP. Over time, we observed decreases in the rates of alcohol consumption, smoking, influenza vaccination, and older patients (age ≥65 years), but increases in admissions to ICU and the need for non-invasive mechanical ventilation. The overall 30-day mortality rate was 8% (95% confidence interval, 6%–9%; 84 of 1,120 patients) and did not change significantly between periods (p = 0.33). Although, we observed a decrease in ICU-mortality comparing the first period (26%) to the second one (10%), statistical differences disappeared with adjustment (p0.38). Conclusion: Over time, 30-day mortality of hospitalized pneumococcal CAP did not change significantly. Nor did it change in the propensity-adjusted multivariable analysis. Since mortality in pneumococcal pneumonia has remained unaltered for many years despite the availability of antimicrobial agents with proven in vitro activity, other non-antibiotic strategies should be investigated. |