[Community-acquired pneumonia referred for hospital management. Its epidemiology and the diagnostic and therapeutic approaches]

Arch Bronconeumol. 1999 Jan;35(1):27-32. doi: 10.1016/s0300-2896(15)30321-5.
[Article in Spanish]


Objectives: To determine the epidemiology of community-acquired pneumonia referred to the hospital and to characterize the diagnostic and therapeutic approach adopted by physicians.

Method: Retrospective epidemiological and descriptive clinical study based on case histories consistent with a diagnosis of community-acquired pneumonia (Fang et al. Medicine, 1990; 69:307-16) of patients referred to hospitals in Soria (Spain) over a period of one year. The patients were grouped by severity and the presence of risk factors for unusual etiology. Initial approaches were compared to those advocated by various sources.

Results: Three hundred eight cases of community-acquired pneumonia were diagnosed, and 82% of the patients were admitted. Mean age was 68 +/- 26 years (43% over 80 years of age). Men accounted for 56%. Two hundred seventeen patients (70%) were classified as seriously ill, 203 (66%) had risk factors for unusual etiology, and 166 (54%) were classified in both categories. Mortality among admitted patients was 13%. Etiological diagnoses did not correspond to the guidelines of the Spanish Society of Pneumology and Chest Surgery (SEPAR), with microbial identification achieved in 5%. Empirical treatment followed SEPAR guidelines in 45% of the cases. The Mensa guidelines were followed in 23% and the Sanford guidelines in 20%.

Conclusions: The incidence of community-acquired pneumonia in this population is 3.2 cases per 1,000 inhabitants/year. The population is mainly elderly and comorbidity is common, although mortality is low. We believe common criteria should be adopted for managing community-acquired pneumonia and that empirical treatment should be directed toward germs identified in each setting, based on appropriate etiological investigation.

Publication types

  • English Abstract

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chi-Square Distribution
  • Child
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / therapy
  • Female
  • Hospitalization* / statistics & numerical data
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Pneumonia / diagnosis
  • Pneumonia / epidemiology*
  • Pneumonia / therapy
  • Referral and Consultation* / statistics & numerical data
  • Retrospective Studies
  • Risk Factors
  • Spain / epidemiology