Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
Department of Pulmonary and Critical Care Medicine, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China; Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China; Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China.
Vaccine. 2020 Dec 14;38(52):8362-8370. doi: 10.1016/j.vaccine.2020.11.004. Epub 2020 Nov 13.
Community-acquired pneumonia (CAP) is one of the major global health problems worldwide. However, the epidemiological information of CAP is limited in China. This study aimed to estimate the incidence rate of CAP and describe the epidemiologic characteristics among the Chinese population.
We conducted a retrospective analysis of CAP incidence using the Chinese Urban Basic Medical Insurance database of 23 provinces in 2016, which covered 427.52 million urban beneficiaries of all age groups in Mainland China. CAP episodes were identified using a diagnosis-term-derived algorithm, and multiple CAP records of one single person within 90 continuous days were considered as one single episode. The incidence rates were calculated and described by sex, age, region, and season.
A total of 1.42 million patients were identified as having one or more CAP episodes, and finally a sum of 1.48 million CAP episodes were counted. The overall incidence of CAP was 7.13 (95% CI: 6.11-8.15) per 1000 person-years, in males 7.32 (95% CI: 6.28-8.35) and females 6.93 (95% CI: 5.92-7.94) per 1000 person-years, respectively. The incidence varied by age with a U-shaped curve peaking in children aged < 5 years old [65.80 (95% CI: 62.52-69.08)] and elderly population aged ≥ 80 years old [14.98 (95% CI: 13.63-16.34)]. The incidence varied markedly by regions. Furthermore, the rate showed a clear seasonal trend, which peaked in spring, decreased in summer and autumn, and re-ascended in winter.
This study reveals a relatively high level of CAP incidence in China. These findings provide baseline data for establishing effective prevention strategies, targeted at susceptible populations, regions, and seasons in China.
社区获得性肺炎（CAP）是全球范围内的主要全球卫生问题之一。然而，中国的 CAP 流行病学信息有限。本研究旨在估计 CAP 的发病率，并描述中国人群的流行病学特征。
我们使用 2016 年中国 23 个省份的中国城市基本医疗保险数据库，对 CAP 发病率进行回顾性分析，该数据库覆盖了中国大陆所有年龄段的 4.2752 亿城市受益人群。使用诊断术语衍生算法确定 CAP 发作，且一个人在 90 天连续时间内有多个 CAP 记录，则视为单个发作。通过性别、年龄、地区和季节描述发病率。
共确定了 142 万名患有一个或多个 CAP 发作的患者，最终统计了 148 万例 CAP 发作。CAP 的总体发病率为每 1000 人年 7.13（95%CI：6.11-8.15），男性为每 1000 人年 7.32（95%CI：6.28-8.35），女性为每 1000 人年 6.93（95%CI：5.92-7.94）。发病率因年龄而异，呈 U 型曲线，在<5 岁儿童中达到高峰[65.80（95%CI：62.52-69.08）]，在≥80 岁的老年人群中达到高峰[14.98（95%CI：13.63-16.34）]。发病率在地区之间差异显著。此外，该发病率呈现明显的季节性趋势，春季最高，夏季和秋季下降，冬季再次上升。
本研究揭示了中国 CAP 发病率较高的情况。这些发现为中国制定针对易感人群、地区和季节的有效预防策略提供了基线数据。
