Increased Risk of Hospitalization for Pneumonia in Italian Adults from 2010 to 2019: Scientific Evidence for a Call to Action
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Statistical Analysis
3. Results
3.1. General Characteristics of Hospitalizations for Pneumonia
3.2. Clinical Characteristics of Patients Hospitalized for Pneumonia
3.3. Trends in Hospitalizations over Time
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total Number of Pneumonia Hospitalizations | Incidence Rate Per 100,000 | % | ||
---|---|---|---|---|
Total | 2,481,213 | 411.2 | 100% | |
Gender | ||||
Male | 1,372,040 | 468.5 | 55.3% | |
Female | 1,109,103 | 357 | 44.7% | |
Age (years) | ||||
<18 | 265,354 | 264.9 | 10.7% | |
18–45 | 150,804 | 71.2 | 6.1% | |
46–65 | 330,032 | 196.1 | 13.3% | |
66–75 | 411,426 | 651.1 | 16.6% | |
76–85 | 747,507 | 1688.50 | 30.1% | |
>85 | 576,095 | 3681.60 | 23.2% | |
Year | ||||
2010 | 218,152 | 365.4 | 8.8% | |
2011 | 223,389 | 374.1 | 9.0% | |
2012 | 220,349 | 369.0 | 8.9% | |
2013 | 229,607 | 384.6 | 9.3% | |
2014 | 241,632 | 404.7 | 9.7% | |
2015 | 255,607 | 428.1 | 10.3% | |
2016 | 246,460 | 412.8 | 9.9% | |
2017 | 267,217 | 447.5 | 10.8% | |
2018 | 282,850 | 473.7 | 11.4% | |
2019 | 295,950 | 495.7 | 11.9% |
ICD9-CM Diagnosis Code | ICD9-CM Diagnosis Description | Diagnostic Groups | Total Specified Cases 2010–2019 | % Specified Cases out of Total Specified Cases 2010–2019 |
---|---|---|---|---|
481 | Pneumococcal pneumonia (Streptococcus pneumoniae) | Specified Pneumonia bacterial | 53,879 | 20.44% |
482.89 | Pneumonia from other specified bacteria | Specified Pneumonia bacterial | 44,947 | 17.05% |
483.0 | Mycoplasma Pneumoniae pneumonia | Specified Pneumonia bacterial | 33,532 | 12.72% |
482.1 | Pseudomonas pneumonia | Specified Pneumonia bacterial | 32,106 | 12.18% |
482.41 | Staphylococcus aureus pneumonia | Specified Pneumonia bacterial | 18,239 | 6.92% |
482.0 | Klebsiella pneumoniae pneumonia | Specified Pneumonia bacterial | 15,824 | 6.00% |
487.0 | Influenza with pneumonia | Specified Pneumonia viral | 14,779 | 5.61% |
482.82 | Escherichia coli pneumonia [E. coli] | Specified Pneumonia bacterial | 7226 | 2.74% |
484.6 | Pneumonia in aspergillosis | Specified Pneumonia fungi | 6525 | 2.47% |
483.1 | Chlamydia Pneumonia | Specified Pneumonia bacterial | 6061 | 2.30% |
482.2 | Haemophilus influenzae pneumonia (H. influenzae) | Specified Pneumonia bacterial | 5777 | 2.19% |
482.30 | Streptococcus pneumonia, unspecified | Specified Pneumonia bacterial | 5301 | 2.01% |
480.1 | Respiratory syncytial virus pneumonia | Specified Pneumonia viral | 4914 | 1.86% |
482.40 | Staph pneumonia, unspecified | Specified Pneumonia bacterial | 3094 | 1.17% |
482.39 | Pneumonia from other Streptococci | Specified Pneumonia bacterial | 2597 | 0.99% |
484.1 | Cytomegalovirus pneumonia | Specified Pneumonia viral | 2548 | 0.97% |
480.0 | Adenovirus Pneumonia | Specified Pneumonia viral | 2359 | 0.89% |
480.2 | Parainfluenza virus pneumonia | Specified Pneumonia viral | 2154 | 0.82% |
482.31 | Streptococcus pneumonia, group A | Specified Pneumonia bacterial | 965 | 0.37% |
482.32 | Streptococcus pneumonia, group B | Specified Pneumonia bacterial | 390 | 0.15% |
484.3 | Pneumonia in whooping cough | Specified Pneumonia bacterial | 225 | 0.09% |
480.3 | SARS pneumonia—Associated coronavirus | Specified Pneumonia viral | 163 | 0.06% |
484.5 | Pneumonia in anthrax | Specified Pneumonia bacterial | 20 | 0.01% |
482.4 | Staph pneumonia | Specified Pneumonia bacterial | 14 | 0.01% |
Total Number of Pneumonia Hospitalizations | Incidence Rate Per 100,000 | % * | ||
---|---|---|---|---|
ICD-9 Pneumonia Code Position | ||||
Principal position | 1,374,227 | 227.7 | 55.4% | |
Second position | 1,106,991 | 183.4 | 44.6% | |
ICD-19 Pneumonia Code | ||||
Unspecified pneumonia | 783,574 | 129.8 | 31.6% | |
Unspecified pneumonia viral | 25,290 | 4.2 | 1.0% | |
Unspecified pneumonia bacterial | 514,174 | 85.2 | 20.7% | |
Unspecified bronchopneumonia | 889,320 | 147.4 | 35.8% | |
Specified pneumonia viral | 24,265 | 4.00 | 1.0% | |
Specified pneumonia bacterial | 224,320 | 37.20 | 9.0% | |
Specified pneumonia fungal | 5719 | 0.90 | 0.2% | |
Other | 10,110 | 1.70 | 0.4% | |
Coinfection | 4441 | 0.70 | 0.2% | |
Comorbidities | ||||
Chronic respiratory disease | 438,730 | 72.7 | 17.7% | |
Chronic cardiovascular disease | 173,437 | 28.7 | 7.0% | |
Chronic kidney disease | 170,136 | 28.2 | 6.9% | |
Cancer | 274,394 | 45.5 | 11.1% | |
Diabetes mellitus | 271,262 | 45 | 10.9% | |
At least one comorbidity | 677,903 | 112.3 | 27.3% | |
At least two comorbidities | 230,401 | 38.2 | 9.3% | |
Three or more comorbidities | 52,023 | 8.6 | 2.1% | |
Discharge disposition | ||||
Routine discharge | 1,775,817 | 294.3 | 71.6% | |
Transfer | 191,474 | 31.7 | 7.7% | |
In-hospital death | 322,474 | 53.4 | 13.0% | |
Other | 191,453 | 31.7 | 7.7% |
Variable | Annual Percent Change | p-Value | |
---|---|---|---|
Raw hospitalization rates | +3.47 | <0.001 | |
Gender | Male | +3.08 | <0.001 |
Female | +3.93 | <0.001 | |
Age (years) | <18 | −4.25 | 0.004 |
18–45 | −1.02 | 0.304 | |
46–65 | +3.67 | <0.001 | |
66–75 | +3.53 | <0.001 | |
76–85 | +4.32 | 0.003 | |
>85 | +7.49 | 0.003 | |
Diagnosis (Position) | Pneumonia in first diagnosis | +1.35 | 0.011 |
Pneumonia in secondary diagnosis | +6.18 | 0.003 | |
Diagnosis | Unspecified pneumonia | +5.48 | 0.002 |
Unspecified pneumonia viral | +4.60 | 0.009 | |
Unspecified pneumonia bacterial | +5.86 | <0.001 | |
Unspecified bronchopneumonia | +0.10 | 0.761 | |
Specified pneumonia viral | +11.62 | 0.003 | |
Specified pneumonia bacterial | +3.33 | 0.003 | |
Specified pneumonia fungi | +6.38 | 0.001 | |
Other | +5.99 | <0.001 | |
Coinfection | +16.11 | 0.001 | |
Comorbidities | Chronic respiratory diseases | +3.60 | <0.001 |
Chronic cardiovascular diseases | +2.85 | <0.001 | |
Chronic kidney diseases | +5.21 | <0.001 | |
Cancer | +3.02 | <0.001 | |
Diabetes | +1.86 | <0.001 | |
Comorbidities (number) | At least one comorbidity | +3.76 | <0.001 |
At least two comorbidities | +2.90 | <0.001 | |
Three or more comorbidities | +2.19 | 0.002 | |
Discharge disposition | Routine discharge | +2.13 | 0.001 |
Transfer | +9.08 | <0.001 | |
In-hospital death | +4.56 | <0.001 | |
Other | +9.00 | <0.001 | |
Hospitalization costs (euro) | +3.95 | <0.001 | |
In-hospital death | +4.60 | <0.001 | |
Length of stay (days) | +0.31 | 0.038 | |
DRG weight * | +0.57 | 0.003 |
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Amodio, E.; Vitale, F.; d’Angela, D.; Carrieri, C.; Polistena, B.; Spandonaro, F.; Pagliaro, A.; Montuori, E.A. Increased Risk of Hospitalization for Pneumonia in Italian Adults from 2010 to 2019: Scientific Evidence for a Call to Action. Vaccines 2023, 11, 187. https://doi.org/10.3390/vaccines11010187
Amodio E, Vitale F, d’Angela D, Carrieri C, Polistena B, Spandonaro F, Pagliaro A, Montuori EA. Increased Risk of Hospitalization for Pneumonia in Italian Adults from 2010 to 2019: Scientific Evidence for a Call to Action. Vaccines. 2023; 11(1):187. https://doi.org/10.3390/vaccines11010187
Chicago/Turabian StyleAmodio, Emanuele, Francesco Vitale, Daniela d’Angela, Ciro Carrieri, Barbara Polistena, Federico Spandonaro, Alessandra Pagliaro, and Eva Agostina Montuori. 2023. "Increased Risk of Hospitalization for Pneumonia in Italian Adults from 2010 to 2019: Scientific Evidence for a Call to Action" Vaccines 11, no. 1: 187. https://doi.org/10.3390/vaccines11010187