Table 1 Case mix for admissions with community-acquired pneumonia, overall and by year of admission: 1995 to 1999 versus 2000 to 2004
| Â | All admissions | Admissions 1995 to 1999 | Admissions 2000 to 2004 | P value |
|---|---|---|---|---|
Admissions, n (%) | 17,869 (5.55) | 5,333 (1.65) | 12,536 (3.89) | Â |
Mean (SD) age, years | 61.6 (17.6) | 60.2 (17.5) | 62.2 (17.6) | <0.001 |
Age, n (%) | Â | Â | Â | Â |
   <16 years | 336 (1.9) | 116 (2.2) | 220 (1.8) |  |
   16 to 24 years | 475 (2.7) | 144 (2.7) | 331 (2.6) |  |
   25 to 34 years | 830 (4.6) | 298 (5.6) | 532 (4.2) |  |
   35 to 44 years | 1,300 (7.3) | 385 (7.2) | 915 (7.3) |  |
   45 to 54 years | 2,184 (12.2) | 686 (12.8) | 1,498 (12.0) |  |
   55 to 64 years | 3,453 (19.3) | 1,087 (20.4) | 2,366 (18.9) |  |
   65 to 74 years | 5,034 (28.2) | 1,632 (30.6) | 3,402 (27.1) |  |
   75 to 84 years | 3,837 (21.5) | 916 (17.2) | 2,921 (23.3) |  |
   85+ years | 420 (2.4) | 69 (1.3) | 351 (2.8) |  |
Gender male, n (%) | 10,271 (57.5) | 3,067 (57.5) | 7,204 (57.5) | 0.954 |
Source of admission, n (%) | Â | Â | Â | <0.001 |
   Ward, same hospital | 9,583 (53.6) | 2,941 (55.2) | 6,645 (53.0) |  |
   A&E, same hospital, clinic or home | 2,888 (16.2) | 788 (14.8) | 2,100 (16.8) |  |
   Other intermediate care area, same hospital | 649 (3.6) | 162 (3.0) | 487 (3.9) |  |
   HDU, same hospital | 1,867 (10.5) | 370 (6.9) | 1,497 (11.9) |  |
   ICU, same hospital | 198 (1.1) | 77 (1.5) | 121 (1.0) |  |
   ICU, other hospital | 1,355 (7.6) | 474 (8.9) | 881 (7.0) |  |
   HDU, other hospital | 157 (0.9) | 44 (0.8) | 113 (0.9) |  |
   Other hospital (not ICU or HDU) | 1,169 (6.5) | 477 (8.9) | 692 (5.5) |  |
Past medical history, n (%) | Â | Â | Â | Â |
   Severe liver problems | 219 (1.2) | 58 (1.1) | 161 (1.3) | 0.274 |
   Very severe cardiovascular disease | 334 (1.9) | 96 (1.8) | 238 (1.9) | 0.656 |
   Steroid treatment | 535 (3.0) | 183 (3.4) | 352 (2.8) | 0.025 |
   Severe respiratory problems | 1,265 (7.1) | 465 (8.7) | 800 (6.4) | <0.001 |
   Chronic renal replacement therapy | 231 (1.3) | 87 (1.6) | 144 (1.2) | 0.009 |
Primary reason for admission, n (%) | Â | Â | Â | <0.001 |
   Viral pneumonia | 361 (2.0) | 164 (3.1) | 197 (1.6) |  |
   Bacterial pneumonia | 6,972 (49.0) | 2,270 (42.6) | 4,702 (37.5) |  |
   Pneumonia, no organism isolated | 10,536 (59.0) | 2,899 (54.3) | 7,637 (60.9) |  |
Secondary reason for admission, n (%) | Â | Â | Â | <0.001 |
   Pre-existing |  |  |  |  |
Obstructive airways disease | 1,309 (7.3) | 423 (7.9) | 886 (7.1) | Â |
Trauma | 119 (0.7) | 32 (0.6) | 87 (0.7) | Â |
Diabetes mellitus | 117 (0.7) | 49 (0.9) | 68 (0.5) | Â |
Chronic neuromuscular disorders | 99 (0.6) | 32 (0.6) | 67 (0.5) | Â |
Alcoholic cirrhosis | 124 (0.7) | 24 (0.5) | 100 (0.8) | Â |
Chronic renal failure | 184 (1.0) | 49 (0.9) | 135 (1.1) | Â |
Pulmonary fibrosis or fibrosing alveolitis | 112 (0.6) | 25 (0.5) | 87 (0.7) | Â |
Asthma attack | 176 (1.0) | 62 (1.2) | 114 (0.9) | Â |
Inhalation pneumonitis (gastrointestinal contents) | 56 (0.3) | 12 (0.2) | 44 (0.4) | Â |
   Occurring as CAP complication |  |  |  |  |
Septic shock/septicaemia | 1,223 (6.8) | 389 (7.3) | 834 (6.6) | Â |
Pleural effusion | 122 (0.7) | 17 (0.3) | 105 (0.8) | Â |
   Could be pre-existing or complication |  |  |  |  |
Acute renal failure | 877 (4.9) | 238 (4.5) | 639 (5.1) | Â |
Cardiac dysrhythmia | 246 (1.4) | 58 (1.1) | 188 (1.5) | Â |
Cardiac failure | 643 (3.6) | 213 (4.0) | 430 (3.4) | Â |
Cardiogenic shock | 59 (0.3) | 22 (0.4) | 37 (0.3) | Â |
Acute myocardial infarction | 218 (1.2) | 55 (1.0) | 163 (1.3) | Â |
Pulmonary embolus (thrombus) | 55 (0.3) | 23 (0.4) | 32 (0.3) | Â |
Status epilepticus or uncontrolled seizures | 91 (0.5) | 32 (0.6) | 59 (0.5) | Â |
Non-cardiogenic pulmonary oedema (ARDS) | 152 (0.9) | 45 (0.8) | 107 (0.9) | Â |
   Other/none | 11,887 (66.5) | 3,533 (66.3) | 8,354 (66.6) |  |
CPR prior to admission, n (%) | 1,080 (6.1) | 396 (7.5) | 684 (5.5) | <0.001 |
Mean (SD) SBP at admission, mmHg | 123.8 (30.9) | 123.5 (32.2) | 123.9 (30.4) | 0.486 |
Mean (SD) heart rate at admission, bpm | 108.6 (24.6) | 110.1 (24.8) | 108.0 (24.5) | <0.001 |
Mechanically ventilated at admission, n (%) | 9,751 (54.6) | 3,009 (56.4) | 6,742 (53.8) | 0.001 |
Sedated or paralysed and sedated for whole of first 24 hours, n (%) | 7,737 (43.3) | 2,676 (50.2) | 5,061 (40.4) | <0.001 |
Median (IQR) lowest total GCS if not sedated/paralysed | 15 (11–15) | 15 (11–15) | 15 (11–15) | 0.249 |
Median (IQR) highest non-ventilated respiratory rate, breaths/minute | 32 (26–40) | 32 (25–40) | 33 (26–40) | 0.030 |
Median (IQR) lowest PaO2, kPa | 9.0 (7.7–10.4) | 9.1 (7.7–10.6) | 8.9 (7.7–10.4) | 0.023 |
Median (IQR) lowest pH | 7.3 (7.2–7.4) | 7.3 (7.2–7.4) | 7.3 (7.2–7.4) | 0.002 |
Median (IQR) associated PaCO2, kPa | 6.7 (5.3–8.6) | 6.5 (5.2–8.3) | 6.7 (5.2–8.3) | <0.001 |
Mean (SD) APACHE II APSa | 15.31 (6.34) | 15.09 (6.25) | 15.40 (6.38) | 0.003 |
Mean (SD) APACHE II scorea | 19.63 (6.89) | 19.37 (6.83) | 19.74 (6.91) | <0.001 |