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

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 pneumoc...

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Autores: 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
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/130723
Acceso en línea:https://hdl.handle.net/2445/130723
Access Level:acceso abierto
Palabra clave:Pneumònia adquirida a la comunitat
Septicèmia
Mortalitat
Malalts hospitalitzats
Community-acquired pneumonia
Septicemia
Mortality
Hospital patients
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spelling Twenty-year trend in mortality among hospitalized patients with pneumococcal community-acquired pneumoniaCillóniz, CatiaLiapikou, AdamantiaMartín Loeches, ManuelGarcia Vidal, CarolinaGabarrús, AlbertCeccato, AdrianMagdaleno, DanielMensa Pueyo, JosepMarco Reverté, FrancescTorres Martí, AntoniPneumònia adquirida a la comunitatSepticèmiaMortalitatMalalts hospitalitzatsCommunity-acquired pneumoniaSepticemiaMortalityHospital patientsBackground 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.Public Library of Science (PLoS)2018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/130723Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1371/journal.pone.0200504PLoS One, 2018, vol. 13, num. 7, p. e0200504https://doi.org/10.1371/journal.pone.0200504cc-by (c) Cillóniz, Catia et al., 2018http://creativecommons.org/licenses/by/3.0/esinfo:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1307232026-05-27T06:46:51Z
dc.title.none.fl_str_mv Twenty-year trend in mortality among hospitalized patients with pneumococcal community-acquired pneumonia
title Twenty-year trend in mortality among hospitalized patients with pneumococcal community-acquired pneumonia
spellingShingle Twenty-year trend in mortality among hospitalized patients with pneumococcal community-acquired pneumonia
Cillóniz, Catia
Pneumònia adquirida a la comunitat
Septicèmia
Mortalitat
Malalts hospitalitzats
Community-acquired pneumonia
Septicemia
Mortality
Hospital patients
title_short Twenty-year trend in mortality among hospitalized patients with pneumococcal community-acquired pneumonia
title_full Twenty-year trend in mortality among hospitalized patients with pneumococcal community-acquired pneumonia
title_fullStr Twenty-year trend in mortality among hospitalized patients with pneumococcal community-acquired pneumonia
title_full_unstemmed Twenty-year trend in mortality among hospitalized patients with pneumococcal community-acquired pneumonia
title_sort Twenty-year trend in mortality among hospitalized patients with pneumococcal community-acquired pneumonia
dc.creator.none.fl_str_mv 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
author Cillóniz, Catia
author_facet 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
author_role author
author2 Liapikou, Adamantia
Martín Loeches, Manuel
Garcia Vidal, Carolina
Gabarrús, Albert
Ceccato, Adrian
Magdaleno, Daniel
Mensa Pueyo, Josep
Marco Reverté, Francesc
Torres Martí, Antoni
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Pneumònia adquirida a la comunitat
Septicèmia
Mortalitat
Malalts hospitalitzats
Community-acquired pneumonia
Septicemia
Mortality
Hospital patients
topic Pneumònia adquirida a la comunitat
Septicèmia
Mortalitat
Malalts hospitalitzats
Community-acquired pneumonia
Septicemia
Mortality
Hospital patients
description 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.
publishDate 2018
dc.date.none.fl_str_mv 2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/130723
url https://hdl.handle.net/2445/130723
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0200504
PLoS One, 2018, vol. 13, num. 7, p. e0200504
https://doi.org/10.1371/journal.pone.0200504
dc.rights.none.fl_str_mv cc-by (c) Cillóniz, Catia et al., 2018
http://creativecommons.org/licenses/by/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Cillóniz, Catia et al., 2018
http://creativecommons.org/licenses/by/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.298079

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