Ontology highlight
ABSTRACT: Background
Community-acquired pneumonia (CAP), especially pneumococcal CAP (P-CAP), is associated with a heavy burden of illness as evidenced by high rates of intensive care unit (ICU) admission, mortality, and costs. Although well-defined acutely, determinants influencing long-term burden are less known. This study assessed determinants of 28-day and 1-year mortality and costs among P-CAP patients admitted in ICUs.Methods
Data regarding all hospital and ICU stays in France in 2014 were extracted from the French healthcare administrative database. All patients admitted in the ICU with a pneumonia diagnosis were included, except those hospitalized for pneumonia within the previous 3 months. The pneumococcal etiology and comorbidities were captured. All hospital stays were included in the cost analysis. Comorbidities and other factors effect on the 28-day and 1-year mortality were assessed using a Cox regression model. Factors associated with increased costs were identified using log-linear regression models.Results
Among 182,858 patients hospitalized for CAP in France for 1 year, 10,587 (5.8%) had a P-CAP, among whom 1665 (15.7%) required ICU admission. The in-hospital mortality reached 22.8% at day 28 and 32.3% at 1 year. The mortality risk increased with age?>?54 years, malignancies (hazard ratio (HR) 1.54, 95% CI [1.23-1.94], p?=?0.0002), liver diseases (HR 2.08, 95% CI [1.61-2.69], p??75 years old, p = 0.008), chronic cardiac (+?11% [0.02-0.19], p?=?0.019), and respiratory diseases (+?11% [0.03-0.18], p = 0.006).Conclusions
P-CAP in ICU-admitted patients was associated with a heavy burden of mortality and costs at one year. Older age was associated with both early and 1-year increased mortality. Malignant and chronic liver diseases were associated with increased mortality, whereas chronic cardiac failure and chronic respiratory disease with increased costs.Trial registration
N/A (study on existing database).
SUBMITTER: Dupuis C
PROVIDER: S-EPMC7798246 | biostudies-literature | 2021 Jan
REPOSITORIES: biostudies-literature
Dupuis Claire C Sabra Ayman A Patrier Juliette J Chaize Gwendoline G Saighi Amine A Féger Céline C Vainchtock Alexandre A Gaillat Jacques J Timsit Jean-François JF
Critical care (London, England) 20210110 1
<h4>Background</h4>Community-acquired pneumonia (CAP), especially pneumococcal CAP (P-CAP), is associated with a heavy burden of illness as evidenced by high rates of intensive care unit (ICU) admission, mortality, and costs. Although well-defined acutely, determinants influencing long-term burden are less known. This study assessed determinants of 28-day and 1-year mortality and costs among P-CAP patients admitted in ICUs.<h4>Methods</h4>Data regarding all hospital and ICU stays in France in 20 ...[more]