1 Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
2 New York City Department of Health and Mental Hygiene, New York, NY, USA.
Public Health Rep. 2018 Sep/Oct;133(5):584-592. doi: 10.1177/0033354918792009.
Death certificate data indicate that the age-adjusted death rate for pneumonia and influenza is higher in New York City than in the United States. Most pneumonia and influenza deaths are attributed to pneumonia rather than influenza. Because most pneumonia deaths occur in hospitals, we analyzed hospital discharge data to provide insight into the burden of pneumonia in New York City.
We analyzed data for New York City residents discharged from New York State hospitals with a principal diagnosis of pneumonia, or a secondary diagnosis of pneumonia if the principal diagnosis was respiratory failure or sepsis, during 2001-2014. We calculated mean annual age-adjusted pneumonia-associated hospitalization rates per 100 000 population and 95% confidence intervals (CIs). We examined data on pneumonia-associated hospitalizations by sociodemographic characteristics and colisted conditions.
During 2001-2014, a total of 495 225 patients residing in New York City were hospitalized for pneumonia, corresponding to a mean annual age-adjusted pneumonia-associated hospitalization rate of 433.8 per 100 000 population (95% CI, 429.3-438.3). The proportion of pneumonia-associated hospitalizations with in-hospital death was 12.0%. The mean annual age-adjusted pneumonia-associated hospitalization rate per 100 000 population increased as area-based poverty level increased, whereas the percentage of pneumonia-associated hospitalizations with in-hospital deaths decreased with increasing area-based poverty level. The proportion of pneumonia-associated hospitalizations that colisted an immunocompromising condition increased from 18.7% in 2001 to 33.1% in 2014.
Sociodemographic factors and immune status appear to play a role in the epidemiology of pneumonia-associated hospitalizations in New York City. Further study of pneumonia-associated hospitalizations in at-risk populations may lead to targeted interventions.
死亡证明数据表明，纽约市的肺炎和流感发病率调整后死亡率高于美国。大多数肺炎和流感死亡归因于肺炎而不是流感。由于大多数肺炎死亡发生在医院，我们分析了医院出院数据，以了解纽约市肺炎的负担。
我们分析了 2001-2014 年期间，有肺炎主要诊断或呼吸衰竭或败血症次要诊断的纽约州医院出院的纽约市居民的数据。我们计算了每 10 万人年龄调整后的肺炎相关住院率及其 95%置信区间（CI）。我们根据社会人口统计学特征和合并条件检查了肺炎相关住院数据。
2001-2014 年，共有 495225 名居住在纽约市的患者因肺炎住院，平均每年调整后的肺炎相关住院率为 433.8 例/10 万人（95%CI，429.3-438.3）。肺炎相关住院中有院内死亡的比例为 12.0%。随着基于地区的贫困水平的增加，每 10 万人年龄调整后的肺炎相关住院率呈上升趋势，而肺炎相关住院中有院内死亡的比例呈下降趋势。伴有免疫功能低下合并症的肺炎相关住院比例从 2001 年的 18.7%上升到 2014 年的 33.1%。
社会人口统计学因素和免疫状态似乎在纽约市肺炎相关住院的流行病学中发挥作用。对高危人群的肺炎相关住院情况进行进一步研究可能会导致针对性的干预措施。
