(354) Severe Community-Acquired Pneumonia: US Patient Characteristics and Hospital Resource Utilization

Introduction: Community-acquired bacterial pneumonia (CABP) is one of the most common and costly causes of hospitalization in the United States and worldwide. Although severe CABP (sCABP) occurs in 10-25% of pneumonia hospitalizations, little is known about baseline patient characteristics, outcomes, and hospital resource utilization (HRU).

Methods: We conducted a retrospective single-group cohort study within the IQVIA hospital charge data master database (~450 hospitals; 8 million inpatient visits/year) among adults hospitalized with CABP requiring admission to the intensive care unit (ICU) from 2018-2021.

Results: Among 24,422 patients who met inclusion criteria, 58.4% were ≥65 years of age and 55.2% were male. The majority of patients were admitted to urban (91.9%), nonteaching (63.3%), large (300+ beds; 50.8%) institutions in the US Southern region (52.3%), with a mean (SD) Charlson Comorbidity Index of 1.35 (2.33). Hypertension (16.7%), diabetes mellitus (15.7%), cardiac arrhythmia (13.1%), chronic obstructive pulmonary disease (12.9%), and myocardial infarction/coronary artery disease (12.1%) were common comorbidities. Mean (SD) hospital and ICU lengths of stay were and corresponding costs were 13.6 (12.1) and 8.7 (9.6) days, respectively. Mean (SD) corresponding costs were $91,965 ($133,734) for hospital stays and $23,847 ($36,760) for intensive care. Hospital mortality was 15.9%, and 1 in 5 survivors (19.9%) required ≥1 hospital readmission within 30 days of discharge, increasing to 1 in 3 (29.9%) by 90 days.

Conclusions: CAP is the most common non-birth–related cause for hospital admissions in the United States. Of the 1 million annual CAP hospital admissions, an estimated 75% are caused by bacterial pathogens. sCABP hospitalizations may number 75,000-190,000 per annum, costing US hospitals between 7 and 17 billion dollars per year in aggregate. In view of such vast expenditures, much research into sCABP’s current epidemiology, microbiology, and prevention and treatment strategies is required in order to improve outcomes.