Recent temporal trends, characteristics and outcomes of patients with non‐COVID‐19 community‐acquired pneumonia at two tertiary hospitals in Australia: an observational study

Abstract

BackgroundCommunity‐acquired pneumonia (CAP) leads to considerable morbidity and mortality globally. However, data on CAP burden in Australia, especially during the coronavirus disease 2019 (COVID‐19) pandemic, are limited.AimsWe characterised and assessed clinical outcomes of non‐COVID‐19 CAP hospitalisations over a 6‐year period at two major hospitals in South Australia.MethodsAll non‐COVID‐19 CAP hospitalisations were identified using the International Statistical Classification of Diseases and Related Health Problems, Tenth revision, Australian modification (ICD‐10‐AM) codes, between 1 January 2018 and 31 December 2023, at two tertiary hospitals in Adelaide. Clinical outcomes included in‐hospital and 30‐day mortality, length of stay (LOS) in, intensive care unit (ICU) admission and 30‐day readmissions. Multilevel regression models were utilised to identify predictors of clinical outcomes.ResultsOver the 6‐year period, there were 7853 non‐COVID‐19 CAP hospitalisations, with a temporal increase from 100 per 100 000 population in 2018 to 208 per 100 000 population in 2023 (P < 0.001). The mean (SD) age was 75.1 (17.6) years, and 54.6% were males. The mean age declined over time (P < 0.05), while other characteristics remained stable. Streptococcus pneumoniae was the most commonly identified bacterium (21.8% of cases). In‐hospital mortality occurred in 7.8% of patients, with 30‐day mortality and readmission rates of 14.3% and 16.9% respectively. LOS declined significantly during the pandemic years; however, mortality remained stable over time. Frailty status, malnutrition and number of comorbidities significantly predicted 30‐day mortality and LOS, in addition to pneumonia severity and ICU admission.ConclusionsThere has been an increasing trend of hospitalisations for non‐COVID‐19 CAP during the COVID‐19 pandemic, with a concomitant trend towards shorter LOS and no significant shift in other clinical outcomes.