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Background: Vaccination against pneumococci is currently the most effective method of protection against pneumococcal infections. The aim of the study was to analyse changes in hospitalisations and in-hospital deaths due to pneumonia before (2009-2016) and after (2017-2020) the introduction of PCV 10 vaccinations in the National Immunisation Programme in Poland., Methods: Data on hospitalisations related to community acquired pneumonia (CAP) in the years 2009-2020 were obtained from the Nationwide General Hospital Morbidity Study. Analyses were made in the age groups: <2, 2-3, 4-5, 6-19, 20-59, 60+ years in 2009-2016 and 2017-2020., Results: Overall, there were 1,503,105 CAP-related hospitalisations in 2009-2020, 0.7% of which were caused by Streptococcus pneumoniae infections. Children <2 years of age were the most frequently hospitalised for CAP per 100,000 population, followed by patients aged 2-3, 4-5 and 60+ years. In the years 2009-2016, the percentage of CAP hospital admissions increased significantly, and after the year 2017, it decreased significantly in each of the age groups (p<0.001). In the years 2009-2016, a significant increase in hospitalisations for Streptococcus pneumoniae infections was observed in the age groups <2, 2-3 and 4-5 years (p<0.05). A significant reduction in hospitalisations was observed in the age groups <2, 20-59 and 60+ in 2017-2020 (p<0.05). In the years 2009-2020, there were 84,367 in-hospital deaths due to CAP, 423 (0.5%) of which due to Streptococcus pneumoniae, with patients mainly aged 60+., Conclusions: Implementation of the PCV vaccination programme has effectively decreased the incidence of CAP hospitalisations, including children <2 years of age. The group that is most at risk of death are persons aged 60+. The results of our study can be useful in evaluating the vaccine efficacy and benefits, and they can be an essential part of public health policy. Effective prevention strategies for CAP should be implemented in different age groups., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier India Pvt Ltd. All rights reserved.)

Introduction: The Raise Awareness of Influenza Strategies in Europe (RAISE) group gathered information about the healthcare burden of influenza (hospitalizations, intensive care unit [ICU] admissions, and excess deaths), surveillance systems, and the vaccine coverage rate (VCR) in older adults in 18 European countries and Israel., Areas Covered: Published medical literature and official medical documentation on the influenza disease burden in the participating countries were reviewed from 2010/11 until the 2022/23 influenza seasons. Information on the framework for monitoring the disease burden and the provision for ensuring older adults had access to vaccination in their respective countries was provided. Data on influenza VCR in older adults were collected for the 2019/20 to 2022/23 influenza seasons. Data are reported descriptively., Expert Opinion: Influenza presents a significant healthcare burden in older adults. Reporting outcomes across participating countries is heterogeneous, highlighting the need for standardized approaches. Although older adults receive free influenza vaccination, vaccine uptake is highly variable among countries. Moreover, hospitalization rates remain high even in countries reporting a high VCR. Increased awareness and education on the burden of disease and the broader use of improved influenza vaccines for older adults may help reduce the disease burden on this population.

Introduction and Objective: Congenital cytomegalovirus (cCMV) infections are common worldwide. CCMV infected newborns are mostly asymptomatic at birth. However, cCMV remains the major infectious cause of congenital abnormalities in the developing foetus and newborns. The aim of the study was to provide recent data on cCMV in Poland., Material and Methods: Aretrospective, population-based study was conducted using data from hospital discharge records of patients hospitalized from 2009-2018. CCMV incidence rates were estimated on the basis of data taken from a Polish hospital morbidity study, carried out by the National Institute of Public Health., Results: The study group consisted of 1,916 hospitalized patients with the first-time diagnosis of cCMV. Among them, 52% were patients up to 30 days of age. The median age was 28 days. The average annual incidence of cCMV was 48 per 100,000 live births (95% CI 23.5-73.4). A significantly higher cCMV incidence rate was observed in patients from more urban than rural regions of Poland (55 per 100,000 vs 39 per 100,000; P<0.001). In the study period, 9 hospital deaths (0.5 % of all patients) were reported. The coexistence of nervous system diseases was observed in 26% of cases and hearing loss in 6% of cases., Conclusions: The significantly more cCMV cases were observed in patients from more urban than rural regions of Poland may suggest the presence of territorial factors related to the cCMV incidence in Poland. The relatively high percentage of newborns with hearing loss or neurologic diseases may require activities aimed at reducing the cCMV incidence. The epidemiological data presented may be useful for comparisons with other geographical regions.

Introduction and Objective: Occupational asbestos exposure is one of the major public health issues. Although asbestos use in Poland has decreased, asbestosis continues to remain an important health concern in the area of occupational medicine. The aim of the study is to perform a descriptive analysis of hospitalization cases in patients suffering from asbestosis in Poland., Material and Methods: The authors used hospital discharge records to conduct a retrospective, population-based study. To estimate the asbestosis hospitalization rate, data from the Nationwide General Hospital Morbidity Study conducted by the National Institute of Public Health were used. Events were defined as in-patient hospital discharges during 2006-2016. 1,101 hospitalization records of 764 patients were included in the study., Results: In the study group of first-time hospitalized patients, the mean and median ages were 68.1 and 69 years, respectively; CI: 67.3-68.9; SD: 11.1, min-max:16-99 years. In this group, significant gender differences were observed (560 males vs. 204 female; P<0.001). No statistical differences were observed regarding the place of residence. During the observation period, 61 in-hospital deaths were reported (8% of all patients), 40 of whom (5.2 % of all patients) took place during the first-time hospitalizations. Asbestosis hospitalizations were mainly clustered in the south-western region, whereas the highest hospitalization rates were clustered in several areas of Poland., Conclusions: The authors believe this study to be the first evaluation of asbestosis in Poland made on the basis of the hospital morbidity database. The data presented may be helpful in comparative studies on the epidemiology of asbestosis across European countries.

Objectives: Hospital payment based on diagnosis-related groups (DRGs) was introduced in Poland in July 2008. We evaluate the impact of this policy on the frequency of hospitalisation for atherosclerosis in internal medicine units of district hospitals and non-public hospitals in Poland., Methods: Data were collected between 2004 and 2012 from each district and non-public hospital participating in the General Hospital Morbidity Study (165 hospitals in total). Atherosclerosis was defined using the ICD-10 code I70. Hospitalisation patterns were examined using interrupted time series with segmented regression analysis., Results: were compared between public and non-public hospitals and across patient age groups., Results: The rate of hospitalisation for atherosclerosis rose by 27.05 per 10,000 total hospitalisations immediately following the implementation of DRGs in 2008. It then rose by 2.5 per 10,000 hospitalisations monthly between 2008-2012. The largest changes were observed for patients aged 85+ and 75-84. Rates rose by 117.5 and 54.2 per 10,000 hospitalisations in these two groups respectively following implementation of DRGs. The response to introduction of DRGs was less striking in non-public hospitals than in public hospitals., Conclusions: Implementation of a DRG-based system in Poland was associated with substantial increases in atherosclerosis hospitalisation rates. Failing to take into account this change in financing and not accounting for long-term trends in hospitalisation rates may result in inaccurate epidemiological data., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Hospitalized children are often treated with antibiotics. However, 30-75% of antibiotic treatment in pediatric hospitals is administrated incorrectly or unreasonably. Implementation of Hospital's Antibiotic Policy (HAP) should improve antibiotic consumption patterns in pediatric wards. The objective of this study was to determine the effectiveness of HAP by assessing antibiotic consumption in the General Pediatric Ward of an academic hospital in the city of Warsaw, Poland before and after this policy was introduced in the years 2012 and 2013, respectively. Antibiotic use was calculated in daily-defined doses (DDDs) per 100 patient-days and DDDs per 100 admissions. Antibiotics were ranked by the volume of DDDs and the number of antibiotics which accounted for 90% and 100% of the total volume: DU90% and DU100% (where DU stands for drug use). The total antibiotic consumption and significantly decreased after the implementation of HAP; DDDs were 2,177.5 before and 1,335.4 after implementation of HAP. The number of DDDs/100 patient-days was also lower; 36.3 vs. 24.9 before and after HAP, respectively. After implementation of HAP a decreased use of ceftriaxone and cefuroxime was observed. The most commonly used antibiotic was amoxicillin with clavulanic acid. The DU100% rates remained the same (8 antibiotics) and DU90% increased (from 3 in 2012 to 5 in 2013). We conclude that implementation of HAP resulted a decreased consumption of antibiotics in the General Pediatric Ward, despite the hardly changed number of children treated with antibiotics.

Introduction: Airway infections represent one of the most common causes of mortality worldwide. The authors sought to describe patients hospitalized for lung and mediastinum abscesses in Poland from 2009 to 2016. To the authors' knowledge, this is the first evaluation of the disease in Poland. Material and methods: The authors conducted a retrospective, populationbased study, using data from 14,932 hospital discharge records. Lung and mediastinum abscesses incidence rates were estimated on the basis of data from a Polish hospital morbidity study, carried out by the National Institute of Public Health. Results: The study group consisted of 12,049 patients (74.3% male and 25.7% female patients) hospitalized for the first time with the diagnosis of lung or mediastinum abscesses. The mean and median age was 57.2 and 59 years, respectively. The mean age was significantly higher in females than males (57.9 years vs. 57 years, p < 0.05). Patients were hospitalized with the following diagnosis: abscess of lung with pneumonia (60.9%), abscess of lung without pneumonia (24.9%), abscess of lung and mediastinum (2.6%), gangrene and necrosis of lung (2.8%), abscess of mediastinum (9.7%). The average annual incidence of lung abscesses, including gangrene or necrosis of lung, was 35.7 per million (95% CI: 34.1-37.4) and the average annual incidence of mediastinum abscess was 4.8 per million (95% CI: 4.3-5.3). The incidence rates for all cases of lung or mediastinum abscesses did not vary significantly between urban and rural regions. Conclusions: Presented recent data on lung and mediastinum abscesses in Poland may be helpful in comparative analyses among European countries. [ABSTRACT FROM AUTHOR]

Objectives: There are limited data on the impact of the COVID-19 outbreak in Poland on newborn health. The aim of the study is to show recent information on hospitalizations of newborns in Poland in the pre-pandemic and COVID-19 pandemic era. Methods: A retrospective, population-based study was conducted using data from hospital discharge records of patients hospitalized in 2017–2021. Results: The data on which the study was based consisted of a substantial number of 104,450 hospitalization records. Annual hospitalization rate was estimated to be 50.3–51.9 per 1,000 in 2017–2019, 56 per 1,000 in 2020 and it rose to 77.7 per 1,000 in 2021. In comparison to the pre-pandemic period, in the COVID-19 era, we observed significantly more hospitalization cases of newborns affected by maternal renal and urinary tract diseases (p < 0.001), syndrome of infant of mother with gestational diabetes (p < 0.001), maternal complications of pregnancy (p < 0.001). In the COVID-19 era, the prevalence of COVID-19 among newborns was 4.5 cases per 1,000 newborn hospitalizations. Conclusion: The COVID-19 pandemic outbreak could significantly contribute to qualitative and quantitative changes in hospitalizations among newborns. [ABSTRACT FROM AUTHOR]

Background: Human respiratory syncytial virus (RSV) is responsible for infections mainly affecting the lower respiratory tract in infants and young children after the first exposure. The aim of the study is to show up-to-date information on RSV hospitalization cases in Poland in children aged < 5 years. Methods: A retrospective, population-based study was conducted using data from hospital discharge records of patients hospitalized from 2010–2020. Results: The study group consisted of 57,552 hospitalizations of RSV children. The mean and median ages were 232 (95% CI: 230–234) and 132 (IQR 63–271) days. The mean annual hospitalization rate for patients with RSV infection was estimated to be 267.5 per 100,000, and the highest was observed in children < 1 year (1132.1 per 100,000). The mean annual hospitalization rate was significantly higher in patients living in urban than rural regions (p < 0.001). A statistically significant increase in the number of hospitalizations was observed (p < 0.0001) during the analyzed period. The seasonal pattern was found with the highest rates of hospitalizations in the January–March period. Conclusions: The increasing RSV hospitalization rate requires further research and may be the basis for urgent healthcare measures. The results may be helpful in comparative analyses in the European and global context. [ABSTRACT FROM AUTHOR]

Background: Influenza constitutes a significant health care burden that can be related to an increased morbidity and mortality. The aim of the study is to show up-to-date information on influenza hospitalization cases in Poland in children aged <5 years. Methods: The data used in the study were hospitalization records from 2015–2019, which had been gathered in a Nationwide General Hospital Morbidity Study and made available by the National Institute of Public Health. Results: 8565 records of patients with influenza were subject to analysis. The mean and median age of the patients were 2.2 and 2.1 years, respectively. Influenza hospitalization incidence was estimated at 90 per 100,000 person-years (PY) in children aged <5 years. The number of hospitalization cases was significantly higher in patients living in urban regions than in those living in rural regions (97 vs. 77 per 100,000 PY; p < 0.001). The age of patients living in urban regions was significantly lower than the age of patients living in rural regions (2.2 vs. 2.3 years; p < 0.001). A statistically significant increase in hospitalization was observed. Conclusions: The reported increasing trend in hospitalizations indicates the need to take focused measures. Presented data may be useful in comparative analyses in a European context. [ABSTRACT FROM AUTHOR]

Introduction. Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology, which affects young adults and is associated with multiple organ involvement and life-threatening complications. The aim of the study was to establish the incidence and prevalence of AOSD in Poland, and factors related to this disease among hospitalized patients. Materials and method. A retrospective, population-based study was conducted, using data from hospital discharge records compiled by the National Institute of Public Health in 2009-2018. Results. Based on hospitalization records and census data in a group of the 1,050 patients included in the study, women were predominant (60%) and patients' mean and median ages at hospitalization were 42 (95% CI: 40.8-42.8) and 38 years, respectively. The average annual incidence rate of AOSD during the 10-year period was established at the level of 0.32/100,000 (95% CI: 0.30-0.34), and the point prevalence at the end of 2018 was 2.7/100,000. The most common comorbidities were: cardiovascular diseases (14%), diseases of the musculoskeletal system and connective tissue (14%), endocrine, nutritional and metabolic diseases (9%). Conclusions. AOSD is a rare disease Poland with gender and territorial differences in incidence ratek, and predominance of cardiovascular diseases among comorbidities. The presented data may be useful for comparisons of the Polish population with other geographical regions. Predominance of patients from urban regions and predominance of women may suggest environmental and personal factors in AOSD development; however, further research seems to be necessary. [ABSTRACT FROM AUTHOR]

Introduction. Paget's disease (PDB) is a focal disorder of bone remodeling that occurs commonly in older people with decreasing prevalence reported in European countries. This disease is most often asymptomatic, but it can cause a variety of medical complications resulting in considerable morbidity and reduced quality of life. There is little information regarding the epidemiology of PDB in Poland. To the best of the authors' knowledge, this is the first large epidemiological analysis of this disease in Poland. Objective. The aim of this study was to analyze factors that may be related to the PDB epidemiology among hospitalized patients in Poland. Materials and method. The analysis was conducted on the basis of population-based administrative data, taken from a Polish hospital morbidity study carried out by the National Institute of Public Health between January 2008 - December 2014. Results. Analyzed data covered 662 hospitalization records. The final study sample comprised 94 (41.8%) male and 131 (58.2%) female patients with first-time hospitalizations for PDB, with a significant predominance of females (P<0.02), and the predominance of patients living in urban (73%) than in rural areas (27%), P<0.001. The average age of the sample was 56.8 years (CI: 54.3-59.3; SD 18.8; range 1-93 years). The number of PDB cases hospitalized in Poland significantly decreased during the analyzed period of time. Conclusions: PDB is a rare disease with decreasing trends observed among hospitalized patients in Poland. The study results may suggest the existence of environmental risk factors for the development of PDB. [ABSTRACT FROM AUTHOR]

• Number of hospitalizations and mortality in Poland due to herpes zoster was relatively small. • Mean annual first-time herpes zoster hospitalization rate was 5.8 per 100,000 person-years. • Over 70 % of hospitalized patients due to herpes zoster were over 60 years old. • Risk factors included female gender, older age and residence in urban areas. The varicella-zoster virus (VZV) is an infectious agent that causes both chickenpox and herpes zoster/shingles (HZ). This infection can take various clinical forms, result in permanent complications, and be a marker of immunosuppression, e.g. in the course of a neoplastic disease. The aim of this study is to analyze epidemiological trends in hospitalization and hospital mortality rate among HZ patients in Poland (2012–2021). Our study is a population-based, retrospective analysis of hospital discharge records of patients with HZ. Data were obtained from the National Institute of Public Health in Poland, and they covered the period from 2012 to 2021. All hospitalization records with primary or secondary ICD-10 B02 code diagnosis were included in the study. We analyzed the total number of 23,432 hospital discharge records of HZ patients in 2012–2021. The study group consisted of 22,169 (94.6 %) hospitalization records of first-time diagnosis of HZ in hospitalized patients: 9,309 males (42 %) and 12,860 females (58 %). In this group, 70.3 % were patients over 60 years old. The mean and median age was 64 and 69 years, respectively. The mean annual first-time hospitalization rate for HZ was estimated to be 5.8 per 100,000 person-years (95 % CI: 4.8–6.7 per 100,000 person-years). The hospitalization rate for HZ was similar during 2012–2019. There was a significant decrease in hospitalizations in 2020–2021 in comparison with the previous years (R2 = 0.42, p < 0.05). Women showed a higher hospitalization rate than men (p < 0.001). Urban residents had a higher hospitalization rate than rural residents (p < 0.001). In the analyzed period, 246 deaths were recorded (1.1 % of all hospitalized HZ patients) −119 males and 127 females. The HZ-related number of hospitalizations and mortality in Poland are relatively low, but HZ is still a significant health problem. Risk factors include female gender, older age and residence in urban areas. [ABSTRACT FROM AUTHOR]