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Disease burden of pneumonia in Korean adults aged over 50 years stratified by age and underlying diseases

  • Lee, Jung Yeon (Department of Internal Medicine, Konkuk University Chungju Hospital) ;
  • Yoo, Chul Gyu (Department of Internal Medicine, Seoul National University Hospital) ;
  • Kim, Hyo-Jin (Outcomes Research/Evidence Based Medicine Team, Market Access Department, Pfizer Pharmaceuticals Korea Ltd.) ;
  • Jung, Ki Suck (Division of Pulmonary Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital) ;
  • Yoo, Kwang Ha (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center)
  • Received : 2014.02.28
  • Accepted : 2014.05.27
  • Published : 2014.11.01

Abstract

Background/Aims: This study was conducted to assess the disease burden of pneumonia according to age and presence of underlying diseases in patients admitted with community-acquired pneumonia (CAP). Methods: We performed a retrospective, observational study and collected data targeting patients with CAP (${\geq}50$ years) from 11 hospitals. Disease burden was defined as total per-capita medical fee, severity (CURB-65), hospital length of stay (LOS), and mortality. Results: Of the 693 enrolled subjects, elderly subjects (age, ${\geq}65$ years) had a higher mean CURB-65 score (1.56 vs. 0.25; p < 0.01) and higher mortality than nonelderly subjects (4.4% [n = 21] vs. 0.5% [n = 1]; p = 0.00). In addition, the total cost of pneumonia treatment was higher in elderly patients compared to in nonelderly patients (KRW 2,088,190 vs. US $1,701,386; p < 0.01). Those with an underlying disease had a higher CURB-65 score (1.26 vs. 0.68; p < 0.01), were much older (mean age, 71.24 years vs. 64.24 years; p < 0.01), and had a higher mortality rate than those without an underlying disease (3.5% [n = 20] vs. 1.7% [n = 2]; p = 0.56). Total per-capita medical fees were higher (KRW 2,074,520 vs. US $1,440,471; p < 0.01) and hospital LOS was longer (mean, 8.38 days vs. 6.42 days; p < 0.01) in patients with underlying diseases compared to those without. Conclusions: Due to the relatively high disease burden in Korea, particularly in the elderly and in those with an underlying disease, closer and more careful observation is needed to improve the outcomes of patients with CAP.

Keywords

Acknowledgement

Supported by : Pfizer Pharmaceuticals Korea Ltd.

References

  1. File TM. Community-acquired pneumonia. Lancet 2003;362:1991-2001. https://doi.org/10.1016/S0140-6736(03)15021-0
  2. Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis 2007;44 Suppl 2:S27-S72. https://doi.org/10.1086/511159
  3. Ewig S, Birkner N, Strauss R, et al. New perspectives on community-acquired pneumonia in 388 406 patients. Results from a nationwide mandatory performance measurement programme in healthcare quality. Thorax 2009;64:1062-1069. https://doi.org/10.1136/thx.2008.109785
  4. Jackson ML, Neuzil KM, Thompson WW, et al. The burden of community-acquired pneumonia in seniors: results of a population-based study. Clin Infect Dis 2004;39:1642-1650. https://doi.org/10.1086/425615
  5. Kaplan V, Angus DC, Griffin MF, Clermont G, Scott Watson R, Linde-Zwirble WT. Hospitalized community-acquired pneumonia in the elderly: age- and sex-related patterns of care and outcome in the United States. Am J Respir Crit Care Med 2002;165:766-772. https://doi.org/10.1164/ajrccm.165.6.2103038
  6. Torres A, Peetermans WE, Viegi G, Blasi F. Risk factors for community-acquired pneumonia in adults in Europe: a literature review. Thorax 2013;68:1057-1065. https://doi.org/10.1136/thoraxjnl-2013-204282
  7. Chong CP, Street PR. Pneumonia in the elderly: a review of the epidemiology, pathogenesis, microbiology, and clinical features. South Med J 2008;101:1141-1145. https://doi.org/10.1097/SMJ.0b013e318181d5b5
  8. Marik PE, Kaplan D. Aspiration pneumonia and dysphagia in the elderly. Chest 2003;124:328-336. https://doi.org/10.1378/chest.124.1.328
  9. Thomsen RW, Riis A, Norgaard M, et al. Rising incidence and persistently high mortality of hospitalized pneumonia: a 10-year population-based study in Denmark. J Intern Med 2006;259:410-417. https://doi.org/10.1111/j.1365-2796.2006.01629.x
  10. Yoo KH, Yoo CG, Kim SK, et al. Economic burden and epidemiology of pneumonia in Korean adults aged over 50 years. J Korean Med Sci 2013;28:888-895. https://doi.org/10.3346/jkms.2013.28.6.888
  11. Song JH, Oh WS, Kang CI, et al. Epidemiology and clinical outcomes of community-acquired pneumonia in adult patients in Asian countries: a prospective study by the Asian network for surveillance of resistant pathogens. Int J Antimicrob Agents 2008;31:107-114. https://doi.org/10.1016/j.ijantimicag.2007.09.014
  12. Kim HI, Kim SW, Chang HH, et al. Mortality of community- acquired pneumonia in Korea: assessed with the pneumonia severity index and the CURB-65 score. J Korean Med Sci 2013;28:1276-1282. https://doi.org/10.3346/jkms.2013.28.9.1276
  13. Weycker D, Strutton D, Edelsberg J, Sato R, Jackson LA. Clinical and economic burden of pneumococcal disease in older US adults. Vaccine 2010;28:4955-4960. https://doi.org/10.1016/j.vaccine.2010.05.030
  14. Thomas CP, Ryan M, Chapman JD, et al. Incidence and cost of pneumonia in medicare beneficiaries. Chest 2012;142:973-981. https://doi.org/10.1378/chest.11-1160
  15. Marston BJ, Plouffe JF, File TM Jr, et al. Incidence of community- acquired pneumonia requiring hospitalization: results of a population-based active surveillance Study in Ohio: the Community-Based Pneumonia Incidence Study Group. Arch Intern Med 1997;157:1709-1718. https://doi.org/10.1001/archinte.1997.00440360129015
  16. Niederman MS, McCombs JS, Unger AN, Kumar A, Popovian R. The cost of treating community-acquired pneumonia. Clin Ther 1998;20:820-837. https://doi.org/10.1016/S0149-2918(98)80144-6
  17. Lindenauer PK, Lagu T, Shieh MS, Pekow PS, Rothberg MB. Association of diagnostic coding with trends in hospitalizations and mortality of patients with pneumonia, 2003-2009. JAMA 2012;307:1405-1413.
  18. Chen YH, Yang GY, Loh CH, et al. Cost benefits of targeting the pneumococcal vaccination program to the elderly population in Taiwan. Am J Infect Control 2006;34:597-599. https://doi.org/10.1016/j.ajic.2006.02.009
  19. Olsen SJ, Laosiritaworn Y, Siasiriwattana S, Chunsuttiwat S, Dowell SF. The incidence of pneumonia in rural Thailand. Int J Infect Dis 2006;10:439-445. https://doi.org/10.1016/j.ijid.2006.06.004
  20. Song JY, Choi JY, Lee JS, et al. Clinical and economic burden of invasive pneumococcal disease in adults: a multicenter hospital-based study. BMC Infect Dis 2013;13:202. https://doi.org/10.1186/1471-2334-13-202
  21. Lee MK. Community acquired pneumonia. Tuberc Respir Dis 2011;70:1-9. https://doi.org/10.4046/trd.2011.70.1.1
  22. Lee JH, Ryu YJ, Chun EM, Chang JH. Outcomes and prognostic factors for severe community-acquired pneumonia that requires mechanical ventilation. Korean J Intern Med 2007;22:157-163. https://doi.org/10.3904/kjim.2007.22.3.157
  23. Viegi G, Pistelli R, Cazzola M, et al. Epidemiological survey on incidence and treatment of community acquired pneumonia in Italy. Respir Med 2006;100:46-55. https://doi.org/10.1016/j.rmed.2005.04.013
  24. Mortensen EM, Coley CM, Singer DE, et al. Causes of death for patients with community-acquired pneumonia: results from the Pneumonia Patient Outcomes Research Team cohort study. Arch Intern Med 2002;162:1059-1064. https://doi.org/10.1001/archinte.162.9.1059

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