Department of Respiratory Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka, 807-8555, Japan.
Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka, 807-8555, Japan.
J Infect Chemother. 2022 Oct;28(10):1364-1369. doi: 10.1016/j.jiac.2022.06.006. Epub 2022 Jun 16.
Pneumococcal pneumonia has a high morbidity and mortality in adults, especially those ≥65 years old. In the past decade, pneumococcal vaccination programs have been initiated worldwide, however, few data concerning mortality changes are available in pneumococcal pneumonia patients and there are no reports clarifying these current changes in Japan.
Japanese patients ≥65 years old hospitalized with pneumococcal pneumonia between April 2012 and March 2018 were analyzed using the Diagnostic Procedure Combination database. In-hospital mortality was evaluated, and the odds ratios for this outcome in each fiscal year compared with that in 2012 was analyzed using multivariable logistic regression models.
Between 2012 and 2017, data of 47,375 pneumococcal pneumonia patients ≥65 years old were extracted. The incidence per 1000 person-years for in-hospital mortality was 60.4 in 2012, 56.8 in 2013, 63.2 in 2014, 56.1 in 2015, 73.0 in 2016, and 67.4 in 2017 and the odds ratios for in-hospital mortality in 2013, 2014, 2015, 2016, and 2017 compared with that in 2012 were 1.00, 1.05, 1.04, 1.06, and 0.98, respectively. There were no significant differences between 2012 and each year from 2013 to 2017. Low BMI; low ADL score; high A-DROP score; comorbid malignancy and heart failure; the coexistence of invasive pneumococcal infection; and the use of invasive mechanical ventilation were independent risk factors for in-hospital mortality.
There were no changes in in-hospital mortality in pneumococcal pneumonia patients between 2012 or each year from 2013 to 2017 and further epidemiological observations are necessary.
肺炎球菌性肺炎在成年人中发病率和死亡率较高，尤其是 65 岁以上的老年人。在过去的十年中，全球已启动了肺炎球菌疫苗接种计划，但关于肺炎球菌性肺炎患者死亡率变化的数据很少，并且尚无关于日本当前变化的报告。
使用诊断程序组合数据库分析了 2012 年 4 月至 2018 年 3 月期间因肺炎球菌性肺炎住院的年龄≥65 岁的日本患者。评估了住院死亡率，并使用多变量逻辑回归模型分析了每个财政年度与 2012 年相比的该结局的优势比。
2012 年至 2017 年期间，提取了 47375 例年龄≥65 岁的肺炎球菌性肺炎患者的数据。2012 年住院死亡率的发病率为每 1000 人年 60.4，2013 年为 56.8，2014 年为 63.2，2015 年为 56.1，2016 年为 73.0，2017 年为 67.4，2013 年，2014 年，2015 年，2016 年和 2017 年的住院死亡率与 2012 年相比的优势比分别为 1.00，1.05，1.04，1.06和 0.98。2012 年与 2013 年至 2017 年的每年之间均无显着差异。低 BMI；低 ADL 评分；高 A-DROP 评分；合并恶性肿瘤和心力衰竭；侵袭性肺炎球菌感染的共存；以及使用有创机械通气是住院死亡率的独立危险因素。
2012 年或 2013 年至 2017 年期间，肺炎球菌性肺炎患者的住院死亡率没有变化，需要进一步进行流行病学观察。
