Lopardo Gustavo Daniel, Fridman Diego, Raimondo Enrique, Albornoz Henry, Lopardo Ana, Bagnulo Homero, Goleniuk Daniel, Sanabria Manuelita, Stamboulian Daniel
Fundación del Centro de Estudios Infectológicos, Buenos Aires, Argentina.
Department of Infectious Diseases, Hospital López Lima, General Roca, Argentina.
BMJ Open. 2018 Apr 10;8(4):e019439. doi: 10.1136/bmjopen-2017-019439.
To determine the incidence rate and mortality of community-acquired pneumonia (CAP) in adults in three cities in Latin America during a 3-year period.
Prospective population-based surveillance study.
Healthcare facilities (outpatient centres and hospitals) in the cities of General Roca (Argentina), Rivera (Uruguay) and Concepción (Paraguay).
2302 adults aged 18 years and older with CAP were prospectively enrolled between January 2012 and March 2015.
Incidence rates of CAP in adults, predisposing conditions for disease, mortality at 14 days and at 1 year were estimated. Incidence rate of CAP, within each age group, was calculated by dividing the number of cases by the person-years of disease-free exposure time based on the last census; incidence rates were expressed per 1000 person-years.
Median age of participants was 66 years, 46.44% were men, 68% were hospitalised. Annual incidence rate was 7.03 (95% CI 6.64 to 7.44) per 1000 person-years in General Roca, 6.33 (95% CI 5.92 to 6.78) per 1000 person-years in Rivera and 1.76 (95% CI 1.55 to 2.00) per 1000 person-years in Concepción. Incidence rates were highest in participants aged over 65 years. 82.4% had at least one predisposing condition and 48% had two or more (multimorbidity). Chronic heart disease (43.6%) and smoking (37.3%) were the most common risk factors. 14-day mortality rate was 12.1% and 1-year mortality was 24.9%. Multimorbidity was associated with an increased risk of death at 14 days (OR 2.91; 95% CI 2.23 to 3.80) and at 1 year (OR 3.00; 95% CI 2.44 to 3.70).
We found a high incidence rate of CAP in adults, ranging from 1.76 to 7.03 per 1000 person-years, in three cities in South America, disclosing the high burden of disease in the region. Efforts to improve prevention strategies are needed.
确定拉丁美洲三个城市成年社区获得性肺炎（CAP）在三年期间的发病率和死亡率。
基于人群的前瞻性监测研究。
罗卡将军城（阿根廷）、里韦拉（乌拉圭）和康塞普西翁（巴拉圭）市的医疗机构（门诊中心和医院）。
2012年1月至2015年3月期间前瞻性纳入2302名18岁及以上的成年CAP患者。
估计成年CAP的发病率、疾病的诱发因素、14天和1年时的死亡率。根据上次人口普查，通过将病例数除以无病暴露时间的人年数，计算每个年龄组内CAP的发病率；发病率以每1000人年表示。
参与者的中位年龄为66岁，46.44%为男性，68%住院治疗。罗卡将军城的年发病率为每1000人年7.03（95%CI 6.64至7.44），里韦拉为每1000人年6.33（CI 5.92至6.78），康塞普西翁为每1000人年1.76（95%CI 1.55至2.00）。65岁以上参与者的发病率最高。82.4%至少有一种诱发疾病，48%有两种或更多（多病共存）。慢性心脏病（43.6%）和吸烟（37.3%）是最常见的危险因素。14天死亡率为12.1%，1年死亡率为24.9%。多病共存与14天（OR 2.91；95%CI 2.23至3.80）和1年（OR 3.00；95%CI 2.44至3.70）时死亡风险增加相关。
我们发现南美洲三个城市成年CAP的发病率较高，每1000人年为1.76至7.03，揭示了该地区疾病负担较重。需要努力改进预防策略。
