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Chest. 2017 Nov;152(5):930-942. doi: 10.1016/j.chest.2017.04.162. Epub 2017 Apr 26.

Burden of Adult Community-acquired, Health-care-Associated, Hospital-Acquired, and Ventilator-Associated Pneumonia: New York City, 2010 to 2014.

Author information

1
Division of Disease Control, New York City Department of Health and Mental Hygiene, Queens, NY.
2
Division of Disease Control, New York City Department of Health and Mental Hygiene, Queens, NY; National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
3
Division of Disease Control, New York City Department of Health and Mental Hygiene, Queens, NY; Career Epidemiology Field Officer Program, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA. Electronic address: nvora@cdc.gov.

Abstract

BACKGROUND:

Although pneumonia is a leading cause of death in New York City (NYC), limited data exist about the settings in which pneumonia is acquired across NYC. Cases of pneumonia acquired in community settings are more likely to be preventable with vaccines and treatable with first-line antibiotics than those acquired in noncommunity settings. The objective of this study was to estimate the burden of hospitalizations associated with community-acquired (CAP), health-care-associated (HCAP), hospital-acquired (HAP), and ventilator-associated (VAP) pneumonia from 2010 to 2014.

METHODS:

This retrospective analysis was performed by using an all-payer reporting system of hospital discharges that included NYC residents aged ≥ 18 years. Pneumonia-associated hospitalizations were defined as any hospitalization that included a diagnostic code for pneumonia among any of the discharge diagnoses. Using published clinical guidelines, we classified hospitalizations into mutually exclusive categories of CAP, HCAP, HAP, and VAP and defined pneumonia acquired in the community setting as the combination of CAP and HCAP.

RESULTS:

Of 4,614,108 hospitalizations during the reporting period, 283,927 (6.2%) involved pneumonia. Among pneumonia-associated hospitalizations, 154,158 (54.3%) were CAP, 85,656 (30.2%) were HCAP, 39,712 (14.0%) were HAP, and 4,401 (1.6%) were VAP. Death during hospitalization occurred in 7.9% of CAP-associated hospitalizations, compared with 15.6% of HCAP-associated hospitalizations, 20.7% of HAP-associated hospitalizations, and 21.6% of VAP-associated hospitalizations.

CONCLUSIONS:

Most pneumonia-associated hospitalizations in NYC involve pneumonias acquired in the community setting. Although 15.6% of pneumonia-associated hospitalizations were categorized as HAP or VAP, these pneumonias accounted for > 25% of deaths from pneumonia-associated hospitalizations. Public health pneumonia prevention efforts need to target both community and hospital settings.

KEYWORDS:

HAIs; administrative data; hospital-acquired infections; pneumonia

PMID:
28455128
DOI:
10.1016/j.chest.2017.04.162
[Indexed for MEDLINE]

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