Population-based incidence and mortality of community-acquired pneumonia in Germany

Abstract

Background Little information on the current burden of community-acquired pneumonia (CAP) in adults in Germany is available. Methods We conducted a retrospective cohort study using a representative healthcare claims database of approx. 4 million adults to estimate the incidence rates (IR) and associated mortality of CAP in 2015. IR and mortality were stratified by treatment setting, age group, and risk group status. A pneumonia coded in the primary diagnosis position or in the second diagnosis position with another pneumonia-related condition coded in the primary position was used as the base cases definition for the study. Sensitivity analyses using broader and more restrictive case definitions were also performed. Results The overall IR of CAP in adults ≥18 years was 1,054 cases per 100,000 person-years of observation. In adults aged 16 to 59 years, IR for overall CAP, hospitalized CAP and outpatient CAP was 551, 96 and 466 (with a hospitalization rate of 17%). In adults aged ≥60 years, the respective IR were 2,032, 1,061 and 1,053 (with a hospitalization rate of 52%). If any pneumonia coded in the primary or secondary diagnosis position was considered for hospitalized patients, the IR increased 1.5-fold to 1,560 in the elderly ≥60 years. The incidence of CAP hospitalizations was substantially higher in adults ≥18 years with at-risk conditions and high-risk conditions (IR of 608 and 1,552, respectively), compared to adults without underlying risk conditions (IR 108). High mortality of hospitalized CAP in adults ≥18 was observed in-hospital (18.5%), at 30 days (22.9%) and at one-year (44.5%) after CAP onset. Mortality was more than double in older adults in comparison to younger patients. Conclusion CAP burden in older adults and individuals with underlying risk conditions was high. Maximizing uptake of existing vaccines for respiratory diseases may help to mitigate the disease burden, especially in times of strained healthcare resources.

Pneumococcal vaccination rates in immunocompromised patients in Germany: A retrospective cohort study to assess sequential vaccination rates and changes over time

“…The Institute for Quality Assurance and Transparency in Healthcare (IQTIG) estimates there to be approximately 255,000 CAP cases annually in Germany (non-hospital acquired and in patients over 18 years) [ 3 ]. A study based on claims data recently published by Theilacker et al [ 4 ] also indicated high CAP incidence rates among adults in Germany; the authors reported an overall incidence rate of 1,054 cases per 100,000 person years of observation for the calendar year 2015. This study also revealed high mortality rates; 18.5% of patients ≥18 years hospitalized with CAP died during their inpatient stay, 22.9% died within 30 days and 44.5% died within one year following CAP onset [ 4 ].…”

“…A study based on claims data recently published by Theilacker et al [ 4 ] also indicated high CAP incidence rates among adults in Germany; the authors reported an overall incidence rate of 1,054 cases per 100,000 person years of observation for the calendar year 2015. This study also revealed high mortality rates; 18.5% of patients ≥18 years hospitalized with CAP died during their inpatient stay, 22.9% died within 30 days and 44.5% died within one year following CAP onset [ 4 ]. CAP also has an impact on healthcare resources; Campling et al [ 5 ] found significantly higher healthcare resource utilization in patients with selected underlying comorbidities after hospitalization forCAP when compared to matched patients without CAP.…”

Incidence, Outcomes and Sex-Related Disparities in Pneumonia: A Matched-Pair Analysis with Data from Spanish Hospitals (2016–2019)

“…The burden imposed by community-acquired pneumonia (CAP) continues to be high in developed countries, especially among adults with underlying clinical risk conditions [ 1 , 2 ]. Incidence has seemingly been growing over the years, and the comorbidity of people affected by CAP needing hospital admission has been reported to be increasing across time [ 3 ].…”

52-year follow-up of a birth cohort reveals a high pneumonia incidence among young men

“…Pneumonia risk factors include low socioeconomic status, smoking, excessive alcohol consumption, chronic respiratory disease, chronic heart, liver and kidney diseases, autoimmune conditions, diabetes or haematological conditions, which are especially described among the elderly [ 8 – 15 ]. However, risk profiles for pneumonia among the young and working-age adult populations are not equally assessed [ 13 , 16 – 20 ].…”