The relative burden of community-acquired pneumonia (CAP) in older adults (≥65 years old) compared to other serious diseases is important to prioritize preventive treatment. A retrospective analysis was conducted using the 2014 National Readmission Database to evaluate the length of stay, inpatient mortality, 30-day readmissions, and costs of CAP compared to diabetes mellitus (DM), myocardial infarction (MI), and stroke. 275,790 hospitalizations were analyzed and represented a national estimate of 616,300 hospitalizations, including 269,961 for CAP, 71,284 for DM, 126,946 for MI, and 148,109 for stroke. The mean length of stay in CAP was 5.2 days, which was higher than DM (4.6) and MI (4.3) but similar to stroke (5.6). The inpatient mortality risk was lower for DM (RR: 0.37, 95% CI: 0.29–0.46) but higher for MI (RR: 1.67, 95% CI: 1.50–1.85) and stroke (RR: 1.67, 95% CI: 1.51–1.83). The median costs for CAP ($7282) were higher compared to DM ($6217) but lower compared to MI ($14,802) and stroke ($8772). The 30-day readmission rate was 17% in CAP, which was higher compared to MI (15%) and stroke (11.5%) and lower compared to DM (20.3%). In patients with CAP, disease burden is on par with other serious diseases. CAP should be prioritized for prevention in older adults with strategies such as vaccination and smoking cessation.

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Background Knowledge about the risk for bleeding in patients with hemophilia (PWH) would be relevant for patients, stakeholders, and policy makers. Objectives To perform a systematic review of the literature on risk assessment models (RAMs) and risk factors for bleeding in PWH on regular prophylaxis. Methods We searched Medline, Embase, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews from inception through August 2019. In duplicate, reviewers screened the articles for inclusion, extracted data, and assessed the risk for bias using the Quality in Prognostic Studies (QUIPS) tool. A qualitative synthesis of the results was not performed due to high heterogeneity in risk factors, outcomes definition and measurement, and statistical analysis of the results. Results From 1843 search results, 10 studies met the inclusion criteria. No RAM for the risk for bleeding in PWH was found. Most studies included only PWH A or both PWH A and B and were conducted in North America or Europe. Only one study had a low risk for bias in all the domains. Eight categories of risk factors were identified. The risk for bleeding was increased when factor levels were lower and in people with a significant history of bleeding or who engaged in physical activities involving contact. Conclusions Our findings suggest that plasma factor levels, history of bleeds, and physical activity should be considered for the derivation analysis when building a RAM for bleeding in PWH, and the role of other risk factors, including antithrombotic treatment and obesity, should be explored.