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2017, Número 2

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Rev Med Inst Mex Seguro Soc 2017; 55 (2)


Carga de hospitalización por neumonía en un hospital terciario español. Período 2009-2014

López-Gobernado M, Pérez-Rubio A, López-García E, Mayo-Iscar A, Eiros JM

Idioma: Español
Referencias bibliográficas: 70
Paginas: 170-175
Archivo PDF: 312.85 Kb.


RESUMEN

Introducción: el objetivo de este trabajo es estimar la carga de hospitalización por neumonía adquirida en la comunidad y neumonía neumocócica en un hospital de nivel terciario del Sistema Nacional de Salud Español.
Métodos: estudio retrospectivo en el que se recogen los datos del Conjunto Mínimo de Datos Básicos que usa códigos clínicos del Código Internacional de Enfermedades, asi como el índice de hospitalización por mil habitantes, la tasa de hospitalización por mil habitantes, el índice de mortalidad y la tasa de letalidad, usando como denominador los datos demográficos de la población del Área de Salud.
Resultados: la descarga de 5758 episodios codificados con los códigos CIE 480 a 486 relativos a neumonía, señalan un índice de hospitalización de 3.54 personas hospitalizadas por cada 1000 habitantes, 65.34% del total de ingresos hospitalarios se produce en los Servicios de Medicina Interna y de Neumología. La estancia media hospitalaria por año es de 16.63 días. La tasa bruta de mortalidad es de 69.15 cada 100 000 y la tasa de letalidad de 19.56%, siendo más elevadas en adultos mayores de 65 años.
Conclusiones: a pesar de las medidas terapéuticas y preventivas actuales, la incidencia y la mortalidad por neumonía adquirida en la comunidad en adultos se mantienen elevadas, lo que justifica fortalecer y abordar nuevas estrategias de concienciación y prevención.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. GBD 2013 Mortality and Causes of Death Collaborators. Global, regional and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385:117-71.

  2. Jain S, Self WH, Wunderink RG, Fakhran S, Balk R, Bramley AM et al. Community-acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med. 2015;373:415-27.

  3. De Miguel DJ. Farmaeconomía en el asma y en la EPOC. Arch Bronconeumol. 2005;41:239-41.

  4. Masa JF, Sobradillo V, Villasante C, Jiménez-Ruiz CA, Fernandez-Fau L, Viejo JL et al. Costes de la EPOC en España. Estimación a partir de un estudio epidemiológico poblacional. Arch Bronconeumol. 2004;40:72-9.

  5. Brown JS. Geography and the aetiology of community-acquired pneumonia. Respirology. 2009;14:1068-1071.

  6. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell D, Dean NC et al. Infectious Disease Society of American/American Thoracic Society consensus guidelines of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44(Suppl 2):S27-72.

  7. Niederman MS, McCombs JS, Unger AN, Kumar A, Popovian R. The cost of treating community-acquired pneumonia. Clin Ther. 1998;20:820-37.

  8. Uematsu H, Kunisawa S, Yamashita K, Imanaka Y. The Impact of patient profiles and procedures on hospitalization costs through length of stay in community-acquired pneumonia patients based on a japanese administrative database. PLoS One. 2015;10:e0125284.

  9. Trotter CL, Stuart JM, George R, Miller E. Increasing hospital admissions for pneumonia, England. Emerg Infect Dis. 2008;14:727-33.

  10. Blanquer J, Sanz F. Neumonía adquirida en la comunidad. Arch Bronconeumol. 2010;46(Suppl 7):26-30.

  11. 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. 2002,165:766-72.

  12. Jackson ML, Neuzil KM, Thompson WW, Shay DK, Yu O, Hanson CA, Jackson LA. The burden of community acquired pneumonia in seniors: Results of a population-based study. Clin Infect Dis. 2004;39:1642-50.

  13. Gil-Prieto R, García-García L, Alvaro-Meca A, Méndez C, García A, de Miguel AG. The burden of hospitalizations for community-acquired pneumonia (CAP) and pneumococcal pneumonia in adults in Spain (2003-2007). Vaccine. 2011;29:412-6.

  14. Carriere KC, Jin Y, Marrie TJ, Predy G, Johnson DH. Outcomes and costs among seniors requiring hospitalization for community-acquired pneumonia in Alberta. J Am Geriatr Soc. 2004;52:31-8.

  15. Monge V, San-Martin M, Gonzalez A. The burden of community-acquired pneumonia in Spain. Eur J Public Health. 2001;11:362-4.

  16. Clark JE, Hammal D, Hampton F, Spencer D, Parker L. Epidemiology of community-acquired pneumonia in children seen in hospital. Epidemiol Infect. 2007;135:262-9.

  17. Vila-Corcoles A, Ochoa-Gondar O, Rodriguez- Blanco T, Raga-Luria X, Gomez-Bertomeu F et al. Epidemiology of community-acquired pneumonia in older adults: A population-based study. Respir Med. 2009;103:309-16.

  18. Bayas JM, Vilella A, San-Martín M, González A, Conesa A, Asenjo MA. Impacto sanitario de los ingresos por neumonía en un hospital de tercer nivel. Med Clin (Barc). 2001;116:694-5.

  19. Giorgi Rossi P, Agabiti N, Faustini A, Ancona C, Tancioni V, Forastiere F et al. The burden of hospitalized pneumonia in Lazio, Italy, 1997-1999. Int J Tuberc Lung Dis. 2004;8:528-36.

  20. Almirall J, Bolibar I, Vidal J, Sauca G, Coll P, Niklasson B et al. Epidemiology of community-acquired pneumonia in adults: A population-based study. Eur Respir J. 2000;15:757-63.

  21. 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. 2002,165:766-72.

  22. Welte T, Torres A, Nathwani D. Clinical and economic burden of community-acquired pneumonia among adults in Europe. Thorax. 2012;67:71-9.

  23. Gilavert MC, Bodí M. Factores pronósticos en la neumonía comunitaria grave. Med Intensiva. 2004;28:419-24.

  24. Miyashita N, Shimizu H, Ouchi K, Kawasaki K, Kawai Y, Obase Y et al. Assessment of the usefulness of sputum gram stains and culture for diagnosis of community- acquired pneumonia requiring hospitalization. Med Sci Monit. 2008;14:171-6.

  25. Garau J, Baquero F, Pérez-Trallero E, Pérez JL, Martín- Sánchez AM, García-Rey C. Factors impacting on length of stay and mortality of community-acquired pneumonia. Clin Microbiol Infect. 2008;14:322-9.

  26. Pérez-Trallero E, Baquero F, García-Rey C, Martín- Herrero JE, Martín-Sánchez AM, Garau J. Factors influencing length of hospital stay in a large singleyear series of community-acquired pneumonia. Clin Microbiol Infect. 2006;12:38.

  27. Pérez-Rubio A, Santos S, Luquero FJ, Tamames S, Cantón B, Castrodeza JJ. Evaluación de la adecuación de las estancias en un hospital de tercer nivel. An Sist Sanit Navar. 2007;30:29-36.

  28. Luquero-Alcalde FJ, Santos-Sánz S, Pérez-Rubio A, Tamames-Gómez S, Cantón-Alvarez MB, Castrodeza- Sanz J. Factors determining inappropriate days of stay in a third-level hospital. Gac Sanit. 2008;22:48-51.

  29. Kothe H, Bauer T, Marre R, Suttorp N, Welte T, Dalhoff K. Outcome of community-acquired pneumonia: Influence of age, residence status and antimicrobial treatment. Eur Respir J. 2008;32:139-46.

  30. Janssens JP, Krause KH. Pneumonia in the very old. Lancet Infect Dis. 2004;4:112-24.

  31. Jehl F, Bedos JP, Poirier R, Leophonte P, Sirot J, Chardon H et al. Nationwide survey on communityacquired pneumococcal pneumonia necessitating hospitalization. Med Mal Infect. 2002;32:267-83.

  32. Braun JJ, de Graaff CS, de Goey J, Zwinderman AH, Petit PL. Community-acquired pneumonia: Pathogens and course in patients admitted to a general hospital. Ned Tijdschr Geneeskd. 2004;148:836-40.

  33. Peiró S, Librero J. Evaluación de la calidad a partir del conjunto mínimo de datos básicos al alta hospitalaria. Rev Neurol. 1999;29:651-61.

  34. Schreyögg J, Stargardt T, Tiemann O, Busse R. Methods to determine reimbursementrates for diagnosis related groups (DRG): A comparison of nine European countries. Health Care Manag Sci. 2006;9:215-23.

  35. Bonten MJ, Huijts SM, Bolkenbaas M, Webber C, Patterson S, Gault S et al. Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults. N Engl J Med. 2015;372:1114-25.

  36. GBD 2013 Mortality and Causes of Death Collaborators. Global, regional and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385:117-71.

  37. Jain S, Self WH, Wunderink RG, Fakhran S, Balk R, Bramley AM et al. Community-acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med. 2015;373:415-27.

  38. De Miguel DJ. Farmaeconomía en el asma y en la EPOC. Arch Bronconeumol. 2005;41:239-41.

  39. Masa JF, Sobradillo V, Villasante C, Jiménez-Ruiz CA, Fernandez-Fau L, Viejo JL et al. Costes de la EPOC en España. Estimación a partir de un estudio epidemiológico poblacional. Arch Bronconeumol. 2004;40:72-9.

  40. Brown JS. Geography and the aetiology of community-acquired pneumonia. Respirology. 2009;14:1068-1071.

  41. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell D, Dean NC et al. Infectious Disease Society of American/American Thoracic Society consensus guidelines of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44(Suppl 2):S27-72.

  42. Niederman MS, McCombs JS, Unger AN, Kumar A, Popovian R. The cost of treating community-acquired pneumonia. Clin Ther. 1998;20:820-37.

  43. Uematsu H, Kunisawa S, Yamashita K, Imanaka Y. The Impact of patient profiles and procedures on hospitalization costs through length of stay in community-acquired pneumonia patients based on a japanese administrative database. PLoS One. 2015;10:e0125284.

  44. Trotter CL, Stuart JM, George R, Miller E. Increasing hospital admissions for pneumonia, England. Emerg Infect Dis. 2008;14:727-33.

  45. Blanquer J, Sanz F. Neumonía adquirida en la comunidad. Arch Bronconeumol. 2010;46(Suppl 7):26-30.

  46. 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. 2002,165:766-72.

  47. Jackson ML, Neuzil KM, Thompson WW, Shay DK, Yu O, Hanson CA, Jackson LA. The burden of community acquired pneumonia in seniors: Results of a population-based study. Clin Infect Dis. 2004;39:1642-50.

  48. Gil-Prieto R, García-García L, Alvaro-Meca A, Méndez C, García A, de Miguel AG. The burden of hospitalizations for community-acquired pneumonia (CAP) and pneumococcal pneumonia in adults in Spain (2003-2007). Vaccine. 2011;29:412-6.

  49. Carriere KC, Jin Y, Marrie TJ, Predy G, Johnson DH. Outcomes and costs among seniors requiring hospitalization for community-acquired pneumonia in Alberta. J Am Geriatr Soc. 2004;52:31-8.

  50. Monge V, San-Martin M, Gonzalez A. The burden of community-acquired pneumonia in Spain. Eur J Public Health. 2001;11:362-4.

  51. Clark JE, Hammal D, Hampton F, Spencer D, Parker L. Epidemiology of community-acquired pneumonia in children seen in hospital. Epidemiol Infect. 2007;135:262-9.

  52. Vila-Corcoles A, Ochoa-Gondar O, Rodriguez- Blanco T, Raga-Luria X, Gomez-Bertomeu F et al. Epidemiology of community-acquired pneumonia in older adults: A population-based study. Respir Med. 2009;103:309-16.

  53. Bayas JM, Vilella A, San-Martín M, González A, Conesa A, Asenjo MA. Impacto sanitario de los ingresos por neumonía en un hospital de tercer nivel. Med Clin (Barc). 2001;116:694-5.

  54. Giorgi Rossi P, Agabiti N, Faustini A, Ancona C, Tancioni V, Forastiere F et al. The burden of hospitalized pneumonia in Lazio, Italy, 1997-1999. Int J Tuberc Lung Dis. 2004;8:528-36.

  55. Almirall J, Bolibar I, Vidal J, Sauca G, Coll P, Niklasson B et al. Epidemiology of community-acquired pneumonia in adults: A population-based study. Eur Respir J. 2000;15:757-63.

  56. 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. 2002,165:766-72.

  57. Welte T, Torres A, Nathwani D. Clinical and economic burden of community-acquired pneumonia among adults in Europe. Thorax. 2012;67:71-9.

  58. Gilavert MC, Bodí M. Factores pronósticos en la neumonía comunitaria grave. Med Intensiva. 2004;28:419-24.

  59. Miyashita N, Shimizu H, Ouchi K, Kawasaki K, Kawai Y, Obase Y et al. Assessment of the usefulness of sputum gram stains and culture for diagnosis of community- acquired pneumonia requiring hospitalization. Med Sci Monit. 2008;14:171-6.

  60. Garau J, Baquero F, Pérez-Trallero E, Pérez JL, Martín- Sánchez AM, García-Rey C. Factors impacting on length of stay and mortality of community-acquired pneumonia. Clin Microbiol Infect. 2008;14:322-9.

  61. Pérez-Trallero E, Baquero F, García-Rey C, Martín- Herrero JE, Martín-Sánchez AM, Garau J. Factors influencing length of hospital stay in a large singleyear series of community-acquired pneumonia. Clin Microbiol Infect. 2006;12:38.

  62. Pérez-Rubio A, Santos S, Luquero FJ, Tamames S, Cantón B, Castrodeza JJ. Evaluación de la adecuación de las estancias en un hospital de tercer nivel. An Sist Sanit Navar. 2007;30:29-36.

  63. Luquero-Alcalde FJ, Santos-Sánz S, Pérez-Rubio A, Tamames-Gómez S, Cantón-Alvarez MB, Castrodeza- Sanz J. Factors determining inappropriate days of stay in a third-level hospital. Gac Sanit. 2008;22:48-51.

  64. Kothe H, Bauer T, Marre R, Suttorp N, Welte T, Dalhoff K. Outcome of community-acquired pneumonia: Influence of age, residence status and antimicrobial treatment. Eur Respir J. 2008;32:139-46.

  65. Janssens JP, Krause KH. Pneumonia in the very old. Lancet Infect Dis. 2004;4:112-24.

  66. Jehl F, Bedos JP, Poirier R, Leophonte P, Sirot J, Chardon H et al. Nationwide survey on communityacquired pneumococcal pneumonia necessitating hospitalization. Med Mal Infect. 2002;32:267-83.

  67. Braun JJ, de Graaff CS, de Goey J, Zwinderman AH, Petit PL. Community-acquired pneumonia: Pathogens and course in patients admitted to a general hospital. Ned Tijdschr Geneeskd. 2004;148:836-40.

  68. Peiró S, Librero J. Evaluación de la calidad a partir del conjunto mínimo de datos básicos al alta hospitalaria. Rev Neurol. 1999;29:651-61.

  69. Schreyögg J, Stargardt T, Tiemann O, Busse R. Methods to determine reimbursementrates for diagnosis related groups (DRG): A comparison of nine European countries. Health Care Manag Sci. 2006;9:215-23.

  70. Bonten MJ, Huijts SM, Bolkenbaas M, Webber C, Patterson S, Gault S et al. Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults. N Engl J Med. 2015;372:1114-25.




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