Adults Hospitalized With Pneumonia in the United States: Incidence, Epidemiology, and Mortality
Adults Hospitalized With Pneumonia in the United States: Incidence, Epidemiology, and Mortality
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DOI：
10.1093/cid/cix647
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发表时间：
2017-12-01
影响因子：
11.8
通讯作者：
Carrico, Ruth M.
中科院分区：
文献类型：
--
作者：
Ramirez, Julio A.;Wiemken, Timothy L.;Carrico, Ruth M.
据估计，美国社区获得性肺炎的负担是巨大的，每年有150万成年人住院治疗。美国的预计死亡率为住院期间死亡10万人，出院一年后死亡48万人。了解社区获得性肺炎（CAP）的负担对于分配预防、管理和研究资源至关重要。本研究的目的是确定路易斯维尔市因CAP住院的成年患者的发病率、流行病学和死亡率，并估计美国成年人群的CAP负担。这是一项基于人群的前瞻性队列研究，研究对象为2014年6月1日至2016年5月31日在肯塔基州路易斯维尔的成年居民。连续住院的CAP患者在路易斯维尔所有成人医院登记。计算每年以人群为基础的CAP发病率。地理空间流行病学用于界定CAP与收入水平、种族和年龄之间的生态关联。在住院期间、住院后30天、6个月和1年评估死亡率。在为期2年的研究中，来自路易斯维尔人口的587499名成年人，发生了186384例住院治疗。共有7449例独特的CAP住院患者被记录在案。年龄调整后的年发病率为每10万成人649例CAP住院患者（95%可信区间为628.2-669.8），对应于美国每年成人CAP住院1591825例。在低收入和黑人/非裔美国人人群中发现了聚集性CAP病例。住院期间死亡率为6.5%，相当于美国每年102821例死亡。30天、6个月和1年的死亡率分别为13.0%、23.4%和30.6%。估计美国CAP的负担是巨大的，每年有150万成年人住院，10万人在住院期间死亡，大约三分之一的CAP住院患者在一年内死亡。
The estimated burden of community-acquired pneumonia in the United States is substantial, with > 1.5 million adults being hospitalized annually. The projected mortality for the US is 100000 deaths occurring during hospitalization, reaching 480000 deaths 1 year after hospital discharge.Understanding the burden of community-acquired pneumonia (CAP) is critical to allocate resources for prevention, management, and research. The objectives of this study were to define incidence, epidemiology, and mortality of adult patients hospitalized with CAP in the city of Louisville, and to estimate burden of CAP in the US adult population.This was a prospective population-based cohort study of adult residents in Louisville, Kentucky, from 1 June 2014 to 31 May 2016. Consecutive hospitalized patients with CAP were enrolled at all adult hospitals in Louisville. The annual population-based CAP incidence was calculated. Geospatial epidemiology was used to define ecological associations among CAP and income level, race, and age. Mortality was evaluated during hospitalization and at 30 days, 6 months, and 1 year after hospitalization.During the 2-year study, from a Louisville population of 587499 adults, 186384 hospitalizations occurred. A total of 7449 unique patients hospitalized with CAP were documented. The annual age-adjusted incidence was 649 patients hospitalized with CAP per 100000 adults (95% confidence interval, 628.2-669.8), corresponding to 1591825 annual adult CAP hospitalizations in the United States. Clusters of CAP cases were found in areas with low-income and black/African American populations. Mortality during hospitalization was 6.5%, corresponding to 102821 annual deaths in the United States. Mortality at 30 days, 6 months, and 1 year was 13.0%, 23.4%, and 30.6%, respectively.The estimated US burden of CAP is substantial, with > 1.5 million unique adults being hospitalized annually, 100000 deaths occurring during hospitalization, and approximately 1 of 3 patients hospitalized with CAP dying within 1 year.