Hospitalizations for Community-Acquired and Non-Ventilator-Associated Hospital-Acquired Pneumonia in Spain: Influence of the Presence of Bronchiectasis. A Retrospective Database Study

To examine and compare in-hospital mortality (IHM) of community-acquired pneumonia (CAP) and non-ventilator hospital-acquired pneumonia (NV-HAP) among patients with or without bronchiectasis (BQ) using propensity score matching. A retrospective observational epidemiological study using the Spanish H...

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Main Authors: Gema Sanchez-Muñoz, Ana López-de-Andrés, Valentín Hernández-Barrera, Fernando Pedraza-Serrano, Rodrigo Jimenez-Garcia, Marta Lopez-Herranz, Luis Puente-Maestu, Javier de Miguel-Diez
Format: Article
Language:English
Published: MDPI AG 2020-07-01
Series:Journal of Clinical Medicine
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Online Access:https://www.mdpi.com/2077-0383/9/8/2339
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Summary:To examine and compare in-hospital mortality (IHM) of community-acquired pneumonia (CAP) and non-ventilator hospital-acquired pneumonia (NV-HAP) among patients with or without bronchiectasis (BQ) using propensity score matching. A retrospective observational epidemiological study using the Spanish Hospital Discharge Records, 2016–17. We identified 257,455 admissions with CAP (3.97% with BQ) and 17,069 with NV-HAP (2.07% with BQ). Patients with CAP and BQ had less comorbidity, lower IHM, and a longer mean length of hospital stay (<i>p</i> < 0.001) than non-BQ patients. They had a higher number of isolated microorganisms, including <i>Pseudomonas aeruginosa</i>. In patients with BQ and NV-HAP, no differences were observed with respect to comorbidity, in-hospital mortality (IHM), or mean length of stay. <i>P. aeruginosa</i> was more frequent (<i>p</i> = 0.028). IHM for CAP and NV-HAP with BQ was 7.89% and 20.06%, respectively. The factors associated with IHM in CAP with BQ were age, comorbidity, pressure ulcers, surgery, dialysis, and invasive ventilation, whereas in NV-HAP with BQ, the determinants were age, metastatic cancer, need for dialysis, and invasive ventilation. Patients with CAP and BQ have less comorbidity, lower IHM and a longer mean length of hospital stay than non-BQ patients. However, they had a higher number of isolated microorganisms, including <i>Pseudomonas aeruginosa</i>. In patients with BQ and NV-HAP, no differences were observed with respect to comorbidity, in-hospital mortality, or mean length of stay, but they had a greater frequency of infection by <i>P. aeruginosa</i> than non-BQ patients. Predictors of IHM for both types of pneumonia among BQ patients included dialysis and invasive ventilation.
ISSN:2077-0383