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Deaths in Bacteremic Pneumococcal Pneumonia

1993; Elsevier BV; Volume: 103; Issue: 3 Linguagem: Inglês

10.1378/chest.103.3.710

1931-3543

Åke Örtqvist, Mats Kalin, Inger Julander, Maurice A. Mufson,

Bacterial Infections and Vaccines

The case fatality rate in bacteremic pneumococcal pneumonia (Pnb) has been reported to be lower in Sweden than in the United States. We retrospectively compared 231 adult Pnb patients in Stockholm (STO), Sweden, with 107 patients infected with the same serotypes or groups in Huntington, WVa (HWV). The total case fatality rate was 11/231 (5 percent) in STO versus 28/107 (26 percent) in HWV (p<0.001), being significantly lower in STO for all age groups. Patients from HWV more often had preexisting chronic diseases, while alcoholism was more prevalent in STO. The case fatality rate was similar among alcoholics in STO and HWV, while it was much higher in nonalcoholic patients with chronic diseases in HWV (22/73;30 percent) than in STO (2/88;2 percent) (p<0.001). No bias was found that could account for more than a small part of the higher case fatality rate in HWV. Thus, underlying chronic diseases in HWV accounted for some of the increased risk of death in this patient group. However, the major part of the difference in death rates between HWV and STO remains unexplained. The case fatality rate in bacteremic pneumococcal pneumonia (Pnb) has been reported to be lower in Sweden than in the United States. We retrospectively compared 231 adult Pnb patients in Stockholm (STO), Sweden, with 107 patients infected with the same serotypes or groups in Huntington, WVa (HWV). The total case fatality rate was 11/231 (5 percent) in STO versus 28/107 (26 percent) in HWV (p<0.001), being significantly lower in STO for all age groups. Patients from HWV more often had preexisting chronic diseases, while alcoholism was more prevalent in STO. The case fatality rate was similar among alcoholics in STO and HWV, while it was much higher in nonalcoholic patients with chronic diseases in HWV (22/73;30 percent) than in STO (2/88;2 percent) (p<0.001). No bias was found that could account for more than a small part of the higher case fatality rate in HWV. Thus, underlying chronic diseases in HWV accounted for some of the increased risk of death in this patient group. However, the major part of the difference in death rates between HWV and STO remains unexplained. Bacteremic Pneumococcal Pneumonia Mortality Rate: Is It Really Different in Sweden?CHESTVol. 103Issue 3PreviewAustrian and Gold1 in 1964 published the results of their observations of 2,000 episodes of community-acquired pneumonia studied in New York City between 1952 and 1962. Of the 2,000 patients, 529 (26.5 percent) were bacteremic with Streptococcus pneumoniae. The mortality rate for the bacteremic patients was 19.5 percent. These investigators noted that 43 percent of the deaths (36 percent in those receiving treatment) occurred within 24 h of admission. Full-Text PDF