Open AccessGender differences in incidence and in‐hospital outcomes of community‐acquired, ventilator‐associated and nonventilator hospital‐acquired pneumonia in Spain
Author(s) -
LópezdeAndrés Ana,
AlbaladejoVicente Romana,
MiguelDiez Javier,
HernándezBarrera Valentín,
Ji Zichen,
ZamoranoLeón José J.,
LopezHerranz Marta,
Carabantes Alarcon David,
JimenezGarcia Rodrigo
Publication year - 2021
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.13762
Subject(s) - medicine , incidence (geometry) , pneumonia , epidemiology , community acquired pneumonia , rate ratio , mortality rate , retrospective cohort study , observational study , ventilator associated pneumonia , risk factor , hospital acquired pneumonia , pediatrics , confidence interval , physics , optics
Aims We aim to compare the incidence and in‐hospital outcomes of community‐acquired pneumonia (CAP), ventilator‐associated pneumonia (VAP) and nonventilator hospital‐acquired pneumonia (NV‐HAP) according to gender. Methods This was a retrospective observational epidemiological study using the Spanish National Hospital Discharge Database for the years 2016 and 2017. Results Of 277 785 hospital admissions, CAP was identified in 257 455 (41.04% females), VAP was identified in 3261 (30.42% females) and NV‐HAP was identified in 17 069 (36.58% females). The incidence of all types of pneumonia was higher amongst males (CAP: incidence rate ratio [IRR] 1.05, 95% CI 1.03‐1.06; VAP: IRR 1.36, 95% CI 1.26‐1.46; and NV‐HAP: IRR 1.16, 95% CI 1.14‐1.18). The crude in‐hospital mortality (IHM) rate for CAP was 11.44% in females and 11.80% in males ( P = .005); for VAP IHM, the rate was approximately 35% in patients of both genders and for NV‐HAP IHM, the rate was 23.97% for females and 26.40% for males ( P < .001). After multivariable adjustment, in patients of both genders, older age and comorbidities were factors associated with IHM in the three types of pneumonia analysed. Female gender was a risk factor for IHM after VAP (OR 1.24; 95% CI 1.06‐1.44), and no gender differences were found for CAP or NV‐HAP. Conclusions Our findings show a difference between females and males, with females presenting a lower incidence of all types of pneumonia. However, female gender was a risk factor for IHM after VAP.