Increasing Hospital Admissions for Pneumonia, England

Trotter, Caroline; Stuart, James M.; George, Robert C.; Miller, Elizabeth

doi:10.3201/eid1405.071011

Cited by 252 publications

(212 citation statements)

References 26 publications

(23 reference statements)

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“…A UK study reported case-fatality rates of 5.6% in those aged <65 years and 47.2% for those aged ≥85 years. This study also found a 12-fold higher OR for death within 30 days of hospital admission for adults aged ≥85 years than for those aged <65 years [20]. With the projected…”

Section: Epidemiology Of Capsupporting

confidence: 50%

Macrolides: Are They Safe Bet in Management of Community Acquired Pneumonia (CAP) in Elderly Patients Admitted to an Intensive Care Unit (ICU)

Inzirillo¹,

Giorgetta²,

Ravalli³

et al. 2017

Insights Chest Dis

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Section: Epidemiology Of Capsupporting

confidence: 50%

Macrolides: Are They Safe Bet in Management of Community Acquired Pneumonia (CAP) in Elderly Patients Admitted to an Intensive Care Unit (ICU)

Inzirillo¹,

Giorgetta²,

Ravalli³

et al. 2017

Insights Chest Dis

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“…Despite these concerns there is a paucity of evidence on relative importance of the various determinants of emergency admissions across all age groups and health conditions and reports on emergency admissions have tended to deal with hospital-based overall admission rates [1] or condition-specific admission rates [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Determinants of Emergency Hospital Admissions among Patients in Blackpool, England: Population-Based Cross-Sectional Study

Agboado¹,

Mills²

2011

J Clinic Res Bioeth

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Objectives: To examine the relative importance of patients' socio-demographic characteristics, health service factors, health conditions, day and season of admission as predictors of emergency admissions among Blackpool residents.Study design: Population-based cross-sectional study using routine patient admission data. Records of admissions among Blackpool patients were analysed to examine the effects of socio-demographic factors, health service factors, health conditions, day and season of admissions on emergency admissions. Principal results:The emergency admission risk has declined over the study period. Compared with admissions in people aged 35 to 44, admissions in those aged 85 and above were 3.2 times more likely to be emergencies. Admissions from 4th IMD quintile areas were 43% more likely to be emergencies compared with those from 2nd IMD quintile areas. Admissions among patients registered with Blackpool GPs were less likely to be emergencies compared with those registered with GPs outside Blackpool. Admissions to geriatric medical specialties were most likely to be emergencies. Emergency admission risk was highest for admissions attributed to accidents. Emergency admission risk was also highest for Saturday admissions and lowest for Wednesday admissions. No significant association was observed between emergency admissions and patients' sex. Conclusions:The risk of emergency admissions among Blackpool patients has declined over the period of this study. Socio-demographic and health service factors, health conditions, day and season of admission were independently associated with emergency admissions. [12]. A provider spell is the time that a patient stays with one hospital care provider from admission to discharge, transfer or death [13]. Records of admission spells for Blackpool patients over the period were extracted for analyses.Emergency admissions are admissions that are unpredictable and at short notice because of clinical needs [12]. Admissions classified as emergencies in this study were those coded as 21, 22, 23, 24 and 28 [12]. Primary diagnoses at admission were classified according to the World Health Organization's ICD-10 (International Classification of Disease, 10 th revision).[14] Specialty classifications used broadly followed those contained in the dataset [12] (see Appendix 1 for details). We used the ONS classification of the seasons used in the excess winter deaths calculations [15]. GP practices were coded A to V to eliminate the risk of identifying patients because of the relatively small practice list sizes.Postcodes of patients' places of residence were linked to their respective 2007 Indices of Multiple Deprivation (IMD) [16] which are composite scores derived from seven deprivation domains. The scores were further grouped into their corresponding national score quintiles -the higher the quintile the more deprived an area is. The resultant dataset was analysed to describe emergency admission patterns and identify factors associated with emergency admission. Statistica...

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“…(12)(13)(14)(15) Elderly people present alterations in the defense mechanisms of the respiratory system, with a decrease in mucociliary clearance and in other mechanical barriers, as well as the aging of the immune system and the presence of comorbidities, which facilitate infection with the various microorganisms that cause the disease. (16) There is evidence that being over 65 years of age-presenting or not presenting with the comorbidities that are characteristic of this age bracket (16,17) -is a risk factor for a worse prognosis in NP.…”

Section: Discussionmentioning

confidence: 99%

Determinantes morfológicos de prognóstico em pneumonia nosocomial: um estudo em autópsias

et al. 2010

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Objective: To determine the prevalence of nosocomial pneumonia in autopsies at a public university hospital; to identify the risk factors for nosocomial pneumonia and the potential prognostic factors associated with fatal nosocomial pneumonia and with fatal aspiration pneumonia; and to determine whether anatomopathological findings correlate with nosocomial pneumonia or aspiration pneumonia. Methods: A retrospective study involving 199 autopsied patients, older than 1 year of age, who had been admitted to the São Paulo State University Botucatu School of Medicine Hospital das Clínicas and died of nosocomial pneumonia (underlying or contributing cause), between 1999 and 2006. Demographic, clinical and anatomopathological variables were tested regarding their association with the outcomes (fatal nosocomial pneumonia and fatal aspiration pneumonia). The significant variables were analyzed using multivariate analysis. Results: The mean age was 59 ± 19 years. The prevalence of nosocomial pneumonia in autopsies was 29%, and the disease was the cause of death in 22.6% of the autopsied patients. Fatal nosocomial pneumonia correlated with the following anatomopathological findings: tobacco-associated structural lesions (OR = 3.23; 95% CI: 1.26-2.95; p = 0.02) and bilateral pneumonia (OR = 3.23; 95% CI: 1.26-8.30; p = 0.01). None of the variables were found to be significantly associated with fatal aspiration pneumonia. Conclusions: In our sample, there was a high prevalence of nosocomial pneumonia, which was responsible for almost 25% of all of the deaths. Smoking-related structural lesions and bilateral pneumonia all favored mortality. These findings corroborate the results of various clinical studies on nosocomial pneumonia.Keywords: Autopsy; Risk factors; Prognosis; Pneumonia, aspiration; Pneumonia/mortality. ResumoObjetivo: Determinar a prevalência de pneumonia nosocomial nas autópsias em um hospital público universitário; identificar os fatores de risco relacionados à pneumonia nosocomial e os potenciais fatores prognósticos relacionados à ocorrência de pneumonia nosocomial fatal; e correlacionar os achados anatomopatológicos com a ocorrência de pneumonia nosocomial e/ou pneumonia aspirativa. Métodos: Estudo retrospectivo de 199 pacientes autopsiados, maiores de 1 ano de idade, internados no Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista entre 1999 e 2006, cuja causa de morte (causa básica ou associada) foi pneumonia nosocomial. Testou-se a associação dos dados demográficos, clínicos e anatomopatológicos com os desfechos pneumonia nosocomial fatal e pneumonia aspirativa fatal. As variáveis significativas entraram na análise multivariada. Resultados: A idade média foi de 59 ± 19 anos. A prevalência de pneumonia nosocomial em autópsias foi 29%, e essa foi a causa mortis de 22,6% dos pacientes autopsiados. A pneumonia nosocomial fatal correlacionou-se com os achados anatomopatológicos de alterações estruturais tabágicas (OR = 3,23; IC95%: 1,26-2,95; p = 0,02) e acom...

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Increasing Hospital Admissions for Pneumonia, England

Cited by 252 publications

References 26 publications

Macrolides: Are They Safe Bet in Management of Community Acquired Pneumonia (CAP) in Elderly Patients Admitted to an Intensive Care Unit (ICU)

Macrolides: Are They Safe Bet in Management of Community Acquired Pneumonia (CAP) in Elderly Patients Admitted to an Intensive Care Unit (ICU)

Determinants of Emergency Hospital Admissions among Patients in Blackpool, England: Population-Based Cross-Sectional Study

Determinantes morfológicos de prognóstico em pneumonia nosocomial: um estudo em autópsias

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