Trends in hospitalizations for community-acquired pneumonia in Spain: 2004 to 2013.

AIM: To describe trends in the incidence and outcomes of community-acquired pneumonia (CAP) hospitalizations in Spain (2004-2013).

METHODS: We used national hospital discharge data to select all hospital admissions for CAP as primary diagnosis. We analyzed incidence, Charlson comorbidity index (CCI), diagnostic and therapeutic procedures, pathogens, length of hospital stay (LOHS), in-hospital mortality (IHM) and readmission.

RESULTS: We identified 959,465 admissions for CAP. Incidence rates of CAP increased significantly over time (from 142.4 in 2004 to 163.87 cases per 100,000 inhabitants in 2013). Time trend analyses showed significant increases in the number of comorbidities and the use of CAT of thorax, red cell transfusion, non-invasive mechanical ventilation and readmissions (all p values<0.05). S. pneumoniae was the most frequent causative agent, but its isolation decreased over time. Overall median of LOHS was 7days and it did not change significantly during the study period. Time trend analyses also showed significant decreases in mortality during admission for CAP. Factor associated with higher IHM included: older age, higher CCI, S. aureus isolated, use of red cell transfusion or mechanical ventilation and readmission.

CONCLUSIONS: The incidence and mortality of CAP have changed in Spain from 2004 to 2013. Although there was an increased incidence of hospitalization for this disease over time, we saw a significant reduction in IHM.