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Title:
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Twenty-year trend in mortality among hospitalized patients with pneumococcal community-acquired pneumonia
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Author:
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Cillóniz, Catia; Liapikou, Adamantia; Martín Loeches, Manuel; Garcia Vidal, Carolina; Gabarrús, Albert; Ceccato, Adrian; Magdaleno, Daniel; Mensa Pueyo, Josep; Marco Reverté, Francesc; Torres Martí, Antoni
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Notes:
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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. |
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Subject(s):
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-Pneumònia adquirida a la comunitat
-Septicèmia
-Mortalitat
-Malalts hospitalitzats
-Community-acquired pneumonia
-Septicemia
-Mortality
-Hospital patients |
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Rights:
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cc-by (c) Cillóniz, Catia et al., 2018
http://creativecommons.org/licenses/by/3.0/es
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Document type:
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Article
Article - Published version |
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Published by:
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Public Library of Science (PLoS)
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