Outcomes in females hospitalised with community-acquired pneumonia are worse than in males

Forest W. Arnold, Timothy L. Wiemken, Paula Peyrani, Mehdi Mirsaeidi, Julio A. Ramirez

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

There is little recent information on sex-specific outcomes of patients with community-acquired pneumonia (CAP). The objective of this study was to determine whether female sex is associated with better clinical outcomes in hospitalised patients with CAP. A secondary analysis was conducted by the Community Acquired Pneumonia Organization regarding male and female patients with CAP from 80 hospitals in 17 countries from June 1, 2001 to August 2, 2011. Outcomes were time to clinical stability, length of stay and in-hospital and 28-day mortality. Propensity-adjusted, multivariate regression models were used to predict the probability of occurrence of each of the study outcomes. There were 6718 patients in this study, of whom 40% were female. The adjusted hazard ratio (HR) for time to clinical stability was 0.91 (95% CI 0.85-0.97; p=0.005). The adjusted HR for length of stay was 0.94 (95% CI 0.88-1.01; p=0.089). The adjusted risk ratio for in-hospital mortality was 1.04 (95% CI 0.86-1.24; p=0.717), and for 28-day mortality was 1.15 (95% CI 1.02-1.30; p=0.018). This study demonstrates that the epidemiology of CAP may be changing, and that females have worse outcomes for CAP than males. They are more likely to take longer to reach clinical stability, have longer hospital stays and are 15% more likely to have died after 28 days. Current pneumonia scoring systems may need to be revised regarding female mortality risk. Copyright

Original languageEnglish (US)
Pages (from-to)1135-1140
Number of pages6
JournalEuropean Respiratory Journal
Volume41
Issue number5
DOIs
StatePublished - May 1 2013
Externally publishedYes

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Pneumonia
Length of Stay
Mortality
Hospital Mortality
Epidemiology
Odds Ratio
Outcome Assessment (Health Care)
Organizations

Keywords

  • Community-acquired pneumonia
  • Female sex
  • Length of stay
  • Mortality
  • Outcomes
  • Quality measures

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Outcomes in females hospitalised with community-acquired pneumonia are worse than in males. / Arnold, Forest W.; Wiemken, Timothy L.; Peyrani, Paula; Mirsaeidi, Mehdi; Ramirez, Julio A.

In: European Respiratory Journal, Vol. 41, No. 5, 01.05.2013, p. 1135-1140.

Research output: Contribution to journalArticle

Arnold, Forest W. ; Wiemken, Timothy L. ; Peyrani, Paula ; Mirsaeidi, Mehdi ; Ramirez, Julio A. / Outcomes in females hospitalised with community-acquired pneumonia are worse than in males. In: European Respiratory Journal. 2013 ; Vol. 41, No. 5. pp. 1135-1140.
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abstract = "There is little recent information on sex-specific outcomes of patients with community-acquired pneumonia (CAP). The objective of this study was to determine whether female sex is associated with better clinical outcomes in hospitalised patients with CAP. A secondary analysis was conducted by the Community Acquired Pneumonia Organization regarding male and female patients with CAP from 80 hospitals in 17 countries from June 1, 2001 to August 2, 2011. Outcomes were time to clinical stability, length of stay and in-hospital and 28-day mortality. Propensity-adjusted, multivariate regression models were used to predict the probability of occurrence of each of the study outcomes. There were 6718 patients in this study, of whom 40{\%} were female. The adjusted hazard ratio (HR) for time to clinical stability was 0.91 (95{\%} CI 0.85-0.97; p=0.005). The adjusted HR for length of stay was 0.94 (95{\%} CI 0.88-1.01; p=0.089). The adjusted risk ratio for in-hospital mortality was 1.04 (95{\%} CI 0.86-1.24; p=0.717), and for 28-day mortality was 1.15 (95{\%} CI 1.02-1.30; p=0.018). This study demonstrates that the epidemiology of CAP may be changing, and that females have worse outcomes for CAP than males. They are more likely to take longer to reach clinical stability, have longer hospital stays and are 15{\%} more likely to have died after 28 days. Current pneumonia scoring systems may need to be revised regarding female mortality risk. Copyright",
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