Hospital Burden of All-Cause Pneumonia and Nonbacteremic Pneumococcal Pneumonia in Adults in France Between 2013 and 2019.

Background: Community-acquired pneumonia (CAP) is associated with significant morbidity and mortality. The study objective was to describe the hospital burden of pneumonia in the adult population in France.
Methods: This retrospective study was conducted from the National Health Insurance Database. All hospitalizations for pneumonia (all-cause) between 2013 and 2019 were included. Different risk categories for patients were established based on pneumococcal vaccine recommendations by French health authorities.
Results: A total of 2 199 240 episodes of CAP were registered over the study period (annual mean, 314 177 [standard deviation, 17 818.6]); 75% occurred in patients aged ≥65 years, among whom 47% were not classified in the moderate- or high-risk categories recommended for French pneumococcal vaccination. The incidence of CAP increased with age (117.9, 395.3, and 1916.7 per 100 000 for the age groups 18-49, 50-64, and ≥65 years, respectively, in 2019). Furthermore, being at risk of pneumococcal disease resulted in more severe outcomes, including longer episode duration (mean, 14 days in low-risk vs 17 days in high-risk patients) and higher risk of referral to critical care units (from 20% to 27%), of rehospitalization up to 180 days (from 39% to 67%), of in-hospital death (from 12% to 19%), and of 1-year mortality (from 26% to 49%).
Conclusions: This study establishes the incidence of CAP in adults in France, describes the significant burden of disease, and highlights the need for better prevention policies.
Competing Interests: Potential conflicts of interest. A. S., M. B., E. B., S. F., J. M., and G. G. are employees of Pfizer. L. W. has received consulting fees from Pfizer for this work and from HEVA and IQVIA, outside the submitted work. A. A., J. T., M. L., N. C., and Y. B. are IQVIA employees, a company which was paid by Pfizer for this work, including manuscript development. M. S. F. reports grants from La Fondation du Souffle, and personal fees from Fisher & Paykel and bioMérieux, outside the submitted work. M. S. F. reports consulting fees from Pfizer for this work.
(© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)