Incidence, Outcomes and Sex-Related Disparities in Pneumonia: A Matched-Pair Analysis with Data from Spanish Hospitals (2016-2019).

Jose M De Miguel-Yanes,David Carabantes-Alarcon,Valentin Hernandez-Barrera,Ana Lopez-De-Andres,Julia Wärnberg,Rodrigo Jiménez-Garcia,Napoleon Perez-Farinos,Javier De Miguel-Diez

doi:10.3390/jcm10194339

Abstract

(1) Background: the purpose of this study is to analyze the incidence and in-hospital mortality (IHM) of community-acquired pneumonia (CAP) needing hospital admission and hospital-acquired pneumonia (HAP) in Spain (2016–2019). (2) Methods: using the Spanish Register of Specialized Care-Basic Minimum Database, we estimated the incidence of CAP and HAP. We matched each woman with a man with an identical age, according to comorbidities. (3) Results: we analyzed 518,838 cases of CAP and 38,705 cases of HAP, and 5192 ventilator-associated HAPs (13.4%). The incidence of CAP increased over time in both men (from 384.5 to 449.8 cases/105 population) and women (from 244.9 to 301.2 cases/105 population). Men showed a 47% higher adjusted incidence of CAP than women. The incidence of HAP increased over time in both men (from 302.3 to 342.2 cases/105 population) and women (from 139.2 to 167.6 cases/105 population). Men showed a 98% higher adjusted incidence of HAP than women. IHM was higher in men admitted for CAP than in women (12.9% vs. 12.2%; p < 0.001), but not in men who developed HAP (28.9% vs. 28.0%; p = 0.107). Men admitted for CAP (OR: 1.13; 95% CI: 1.10–1.15) and men who developed HAP (OR: 1.05; 95% CI: 1.01–1.10) had higher IHM than women. (4) Conclusions: men had higher incidence rates of CAP and HAP than women. Men admitted for CAP and men who developed HAP had higher IHM than women.

Highlights

The burden imposed by community-acquired pneumonia (CAP) continues to be high in developed countries, especially among adults with underlying clinical risk conditions [1,2].Incidence has seemingly been growing over the years, and the comorbidity of people affected by CAP needing hospital admission has been reported to be increasing across time [3]. 4.0/).Hospital-acquired pneumonia (HAP) is the second leading cause of nosocomial infection [4]
Important efforts have been put in place to reduce its morbimortality and associated health costs, and these have been mainly successful in the case of ventilator-associated pneumonia (VAP) [5]
People older than 19 years admitted to the hospital for either CAP or who developed hospital-acquired pneumonia (HAP) during admission for another condition were included in the study

Summary

Introduction

The burden imposed by community-acquired pneumonia (CAP) continues to be high in developed countries, especially among adults with underlying clinical risk conditions [1,2].Incidence has seemingly been growing over the years, and the comorbidity of people affected by CAP needing hospital admission has been reported to be increasing across time [3]. 4.0/).Hospital-acquired pneumonia (HAP) is the second leading cause of nosocomial infection [4]. The burden imposed by community-acquired pneumonia (CAP) continues to be high in developed countries, especially among adults with underlying clinical risk conditions [1,2]. Incidence has seemingly been growing over the years, and the comorbidity of people affected by CAP needing hospital admission has been reported to be increasing across time [3]. Hospital-acquired pneumonia (HAP) is the second leading cause of nosocomial infection [4]. Important efforts have been put in place to reduce its morbimortality and associated health costs, and these have been mainly successful in the case of ventilator-associated pneumonia (VAP) [5]. VAP only represents a fraction of all HAPs. voices have been raised to implement strategies to reduce the impact of non-ventilator-associated

Objectives

Methods

Conclusion