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

• Published in: Journal of clinical medicine Vol. 9; no. 8; p. 2339
• Main Authors: Sanchez-Muñoz, Gema, López-de-Andrés, Ana, Hernández-Barrera, Valentín, Pedraza-Serrano, Fernando, Jimenez-Garcia, Rodrigo, Lopez-Herranz, Marta, Puente-Maestu, Luis, Miguel-Diez, Javier de
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 22.07.2020; MDPI
• Subjects: bronchiectasis; Clinical medicine; Codes; community-acquired pneumonia; Comorbidity; Disease; Hospitalization; hospitalizations; Hospitals; in-hospital mortality; Length of stay; Mortality; non-ventilator hospital-acquired pneumonia; Pathogens; Patients; Pneumonia; Pressure ulcers; Streptococcus infections; Variables; Ventilators; Spain
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm9082339

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 (p < 0.001) than non-BQ patients. They had a higher number of isolated microorganisms, including Pseudomonas aeruginosa. In patients with BQ and NV-HAP, no differences were observed with respect to comorbidity, in-hospital mortality (IHM), or mean length of stay. P. aeruginosa was more frequent (p = 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 Pseudomonas aeruginosa. 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 P. aeruginosa than non-BQ patients. Predictors of IHM for both types of pneumonia among BQ patients included dialysis and invasive ventilation.