Abstract
Pneumonia is one of the main causes of hospitalization and mortality. It’s the fourth leading cause of death worldwide. Healthcare-associated infections are the most frequent complication of healthcare and affect hundreds of millions of patients around the world, although the actual number of patients affected is unknown due to the difficulty of reliable data. The main goal of this manuscript is to describe the epidemiological characteristics of patients admitted with pneumonia and the impact of healthcare-associated pneumonia (HCAP) in those patients. It is a quantitative descriptive study with retrospective analysis of the clinical processes of 2436 individuals for 1 year (2018) with the diagnosis of pneumonia. The individuals with ≤5 years old represented 10.4% (n = 253) and ≥65 were 72.6% (n = 1769). 369 cases resulted in death, which gives a sample lethality rate of 15.2%. The severity and mortality index were not sensitive to the death event. We found 30.2% (n = 735) individuals with HCAP and 0.41% (n = 59) with ventilator-associated pneumonia (VAP). In only 59 individuals (2.4%) the agent causing pneumonia was isolated. The high fatality rate obtained shows that pneumonia is a major cause of death in vulnerable populations. Moreover, HCAP is one of the main causes of hospital admissions from pneumonia and death and the most pneumonias are treated empirically. Knowledge of the epidemiology characterization of pneumonia, especially associated with healthcare, is essential to increase the skills of health professionals for the prevention and efficient treatment of pneumonia.
Highlights
Within healthcare-associated pneumonia (HCAP) we find the pneumonia acquired by the Hospital (HAP) and the pneumonia associated with the respirator (VAP)
The individuals included in the sample were classified as pneumonia, according to the Homogeneous Diagnostic Groups (HDG), according to the All Patient Refined Diagnosis Related Groups (DRG) (APR-DRG) which is a classification system for patients admitted to acute hospitals that incorporate severity of illness
At the top of the list of isolations we find Klebsiella pneumoniae, which can indicate that the trend of respiratory isolations has changed in the last years and we can highlight the increase of relevance of Gram-negative microorganisms [41]
Summary
Along with other lower respiratory tract infections, is the fourth leading cause of death worldwide, accounting for over 4 million deaths per year [1,2]. At the European Union, pneumonia remains the most frequent cause of death from infection, especially in the elderly [3]. In Portugal, pneumonia is one of the main causes of hospitalization and mortality. In 2018, about 40,345 patients were hospitalized with the diagnosis of pneumonia and the associated mortality rate was 20.3% [4]
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