Filipe Froes1. 1. Pneumologia do Hospital de Pulido Valente.
Abstract
OBJECTIVE: To characterise the incidence and mortality in adult inpatients with community-acquired pneumonia at a global and regional level in mainland Portugal. PATIENTS AND METHODS: We used the clinical database belonging to the Ministry of Health's Instituto de Gestão e Informática Financeira (Institute of Financial Management and Informatics), which contains the encoded information from the discharge letters from all hospitalisations at National Health Service institutions in mainland Portugal. We conducted a retrospective analysis of all hospitalisations in 1998, 1999 and 2000 with a main diagnosis of pneumonia on admission (ICD9: 480 to 486 and 487.0), excluding patients infected with the human immunodeficiency virus. RESULTS: From 1998 to 2000, hospitalisation of adults with pneumonia represented about 3% of the total number of admissions. We determined an average annual incidence of 2.66 hospitalisations for pneumonia per 1,000 adult inhabitants and of 9.78 per 1,000 inhabitants aged > or =65. The average age of the adults interned was 70, with 71.6% of the patients aged > or =65. We believe that 25 to 50% of adults with community-acquired pneumonia are hospitalised. The mortality rate of adults hospitalised was 17.3%, with no significant difference between the sexes. Mortality rose to 21.5% and 24.8% in individuals aged > or =65 and > or =75, respectively. On average, 2.8% of the adults admitted were given mechanical ventilation and their mortality rate was 43.9%. The incidence of hospitalisations for community-acquired pneumonia and its mortality differed from region to region in mainland Portugal. The annual incidence of admissions for pneumonia per 1,000 adult inhabitants in the central region was double that in the northern region and the Algarve and the mortality rate increased from north to south of the country, with a difference of more than 50% in the Algarve in relation to the northern region. CONCLUSIONS: The incidence of hospitalisations for community-acquired pneumonia is comparable to the figures published in the international literature, though the hospital mortality rate is higher. We feel that it is essential to conduct more studies with a view to a more detailed characterisation of the situation in Portugal and a better understanding of the reasons for the discrepancies between the regions. This would possibly also enable us to implement measures to reduce the mortality rate.
OBJECTIVE: To characterise the incidence and mortality in adult inpatients with community-acquired pneumonia at a global and regional level in mainland Portugal. PATIENTS AND METHODS: We used the clinical database belonging to the Ministry of Health's Instituto de Gestão e Informática Financeira (Institute of Financial Management and Informatics), which contains the encoded information from the discharge letters from all hospitalisations at National Health Service institutions in mainland Portugal. We conducted a retrospective analysis of all hospitalisations in 1998, 1999 and 2000 with a main diagnosis of pneumonia on admission (ICD9: 480 to 486 and 487.0), excluding patients infected with the human immunodeficiency virus. RESULTS: From 1998 to 2000, hospitalisation of adults with pneumonia represented about 3% of the total number of admissions. We determined an average annual incidence of 2.66 hospitalisations for pneumonia per 1,000 adult inhabitants and of 9.78 per 1,000 inhabitants aged > or =65. The average age of the adults interned was 70, with 71.6% of the patients aged > or =65. We believe that 25 to 50% of adults with community-acquired pneumonia are hospitalised. The mortality rate of adults hospitalised was 17.3%, with no significant difference between the sexes. Mortality rose to 21.5% and 24.8% in individuals aged > or =65 and > or =75, respectively. On average, 2.8% of the adults admitted were given mechanical ventilation and their mortality rate was 43.9%. The incidence of hospitalisations for community-acquired pneumonia and its mortality differed from region to region in mainland Portugal. The annual incidence of admissions for pneumonia per 1,000 adult inhabitants in the central region was double that in the northern region and the Algarve and the mortality rate increased from north to south of the country, with a difference of more than 50% in the Algarve in relation to the northern region. CONCLUSIONS: The incidence of hospitalisations for community-acquired pneumonia is comparable to the figures published in the international literature, though the hospital mortality rate is higher. We feel that it is essential to conduct more studies with a view to a more detailed characterisation of the situation in Portugal and a better understanding of the reasons for the discrepancies between the regions. This would possibly also enable us to implement measures to reduce the mortality rate.