Olasupo Omotola, Xiao Hong, Brown Joshua D
Department of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, FL 32610, USA.
Vaccines (Basel). 2018 Aug 31;6(3):59. doi: 10.3390/vaccines6030059.
The relative burden of community-acquired pneumonia (CAP) in older adults (≥65 years old) compared to other serious diseases is important to prioritize preventive treatment. A retrospective analysis was conducted using the 2014 National Readmission Database to evaluate the length of stay, inpatient mortality, 30-day readmissions, and costs of CAP compared to diabetes mellitus (DM), myocardial infarction (MI), and stroke. 275,790 hospitalizations were analyzed and represented a national estimate of 616,300 hospitalizations, including 269,961 for CAP, 71,284 for DM, 126,946 for MI, and 148,109 for stroke. The mean length of stay in CAP was 5.2 days, which was higher than DM (4.6) and MI (4.3) but similar to stroke (5.6). The inpatient mortality risk was lower for DM (RR: 0.37, 95% CI: 0.29⁻0.46) but higher for MI (RR: 1.67, 95% CI: 1.50⁻1.85) and stroke (RR: 1.67, 95% CI: 1.51⁻1.83). The median costs for CAP ($7282) were higher compared to DM ($6217) but lower compared to MI ($14,802) and stroke ($8772). The 30-day readmission rate was 17% in CAP, which was higher compared to MI (15%) and stroke (11.5%) and lower compared to DM (20.3%). In patients with CAP, disease burden is on par with other serious diseases. CAP should be prioritized for prevention in older adults with strategies such as vaccination and smoking cessation.
与其他严重疾病相比，社区获得性肺炎（CAP）在老年人（≥65岁）中的相对负担对于确定预防性治疗的优先顺序很重要。利用2014年全国再入院数据库进行了一项回顾性分析，以评估与糖尿病（DM）、心肌梗死（MI）和中风相比，CAP的住院时间、住院死亡率、30天再入院率和费用。分析了275,790例住院病例，代表全国估计的616,300例住院病例，其中包括269,961例CAP、71,284例DM、126,946例MI和148,109例中风。CAP的平均住院时间为5.2天，高于DM（4.6天）和MI（4.3天），但与中风（5.6天）相似。DM的住院死亡风险较低（RR：0.37，95%CI：0.29⁻0.46），但MI（RR：1.67，95%CI：1.50⁻1.85）和中风（RR：1.67，95%CI：1.51⁻1.83）的住院死亡风险较高。CAP的中位数费用（7282美元）高于DM（6217美元），但低于MI（14,802美元）和中风（8772美元）。CAP的30天再入院率为17%，高于MI（15%）和中风（11.5%），低于DM（20.3%）。在CAP患者中，疾病负担与其他严重疾病相当。对于老年人，应优先通过疫苗接种和戒烟等策略预防CAP。
