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

Little information on the current burden of community-acquired pneumonia (CAP) in adults in Germany is available. 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 C...

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Bibliographic Details
Published in:PloS one 2021-06, Vol.16 (6), p.e0253118-e0253118
Main Authors: Theilacker, Christian, Sprenger, Ralf, Leverkus, Friedhelm, Walker, Jochen, Häckl, Dennis, von Eiff, Christof, Schiffner-Rohe, Julia
Format: Article
Language:English
Subjects:
Adults
Age
Aging
Antibiotics
Asthma
Biology and Life Sciences
Care and treatment
Casualties
Chronic obstructive pulmonary disease
Codes
Community-acquired infections
Computer centers
Congestive heart failure
Diabetes mellitus
Diagnosis
Disease
Dosage and administration
Health care
Health risks
Hospitalization
Hospitals
Immunization
Immunosenescence
Immunosuppression
Influenza
Intensive care
Lung diseases
Medicine and Health Sciences
Mortality
Obstructive lung disease
Older people
Pandemics
Patient outcomes
Patients
People and Places
Pneumococcal vaccine
Pneumonia
Population
Public health
Respiratory diseases
Risk analysis
Risk factors
Severe acute respiratory syndrome coronavirus 2
Software
Vaccination
Vaccines
Viral diseases
Viral pneumonia
Viruses
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Description
Summary:Little information on the current burden of community-acquired pneumonia (CAP) in adults in Germany is available. 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. The overall IR of CAP in adults [greater than or equal to]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 [greater than or equal to]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 [greater than or equal to]60 years. The incidence of CAP hospitalizations was substantially higher in adults [greater than or equal to]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 [greater than or equal to]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. 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.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0253118