Twenty-year trend in mortality among hospitalized patients with pneumococcal community-acquired pneumonia

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RECERCAT Home > Universitat de Barcelona > Medicina > Articles publicats en revistes (Medicina) > View document

To access the full text documents, please follow this link: http://hdl.handle.net/2445/128562

dc.contributor	Universitat de Barcelona
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.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.
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

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