Incidence of acute lower respiratory tract disease hospitalisations, including pneumonia, among adults in Bristol, UK, 2019, estimated using both a prospective and retrospective methodology
Objectives To determine the disease burden of acute lower respiratory tract disease (aLRTD) and its subsets (pneumonia, lower respiratory tract infection (LRTI) and heart failure) in hospitalised adults in Bristol, UK.Setting Single-centre, secondary care hospital, Bristol, UK.Design We estimated aL...
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BMJ Publishing Group
2022-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e057464.full |
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| author | Jo Southern Adam Finn Catherine Hyams James Campling Bradford D Gessner Elizabeth Begier Maria Garcia Gonzalez Sharon Gray Jennifer Oliver |
| author_facet | Jo Southern Adam Finn Catherine Hyams James Campling Bradford D Gessner Elizabeth Begier Maria Garcia Gonzalez Sharon Gray Jennifer Oliver |
| author_sort | Jo Southern |
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| description | Objectives To determine the disease burden of acute lower respiratory tract disease (aLRTD) and its subsets (pneumonia, lower respiratory tract infection (LRTI) and heart failure) in hospitalised adults in Bristol, UK.Setting Single-centre, secondary care hospital, Bristol, UK.Design We estimated aLRTD hospitalisations incidence in adults (≥18 years) in Bristol, UK, using two approaches. First, retrospective International Classification of Diseases 10th revision (ICD-10) code analysis (first five positions/hospitalisation) identified aLRTD events over a 12-month period (March 2018 to February 2019). Second, during a 21-day prospective review (19 August 2019 to 9 September 2019), aLRTD admissions were identified, categorised by diagnosis and subsequently annualised. Hospital catchment denominators were calculated using linked general practice and hospitalisation data, with each practice’s denominator contribution calculated based on practice population and per cent of the practices’ hospitalisations admitted to the study hospital.Participants Prospective review: 1322 adults screened; 410 identified with aLRTD. Retrospective review: 7727 adult admissions.Primary and secondary outcome measures The incidence of aLRTD and its subsets in the adult population of Southmead Hospital, Bristol UK.Results Based on ICD-10 code analysis, annual incidences per 100 000 population were: aLRTD, 1901; pneumonia, 591; LRTI, 739; heart failure, 402. aLRTD incidence was highest among those ≥65 years: 65–74 (3684 per 100 000 adults), 75–84 (6962 per 100 000 adults) and ≥85 (11 430 per 100 000 adults). During the prospective review, 410/1322 (31%) hospitalised adults had aLRTD signs/symptoms and annualised incidences closely replicated retrospective analysis results.Conclusions The aLRTD disease burden was high, increasing sharply with age. The aLRTD incidence is probably higher than estimated previously due to criteria specifying respiratory-specific symptoms or radiological change, usage of only the first diagnosis code and mismatch between case count sources and population denominators. This may have significant consequences for healthcare planning, including usage of current and future vaccinations against respiratory infection. |
| format | Article |
| id | doaj-art-1b0da58487db427c82adaf0e8a96245b |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-1b0da58487db427c82adaf0e8a96245b2025-01-27T14:05:12ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-057464Incidence of acute lower respiratory tract disease hospitalisations, including pneumonia, among adults in Bristol, UK, 2019, estimated using both a prospective and retrospective methodologyJo Southern0Adam Finn1Catherine Hyams2James Campling3Bradford D Gessner4Elizabeth Begier5Maria Garcia Gonzalez6Sharon Gray7Jennifer Oliver8Vaccines Medical Affairs, Pfizer Ltd, Tadworth, Surrey, UKNational Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Behavioural Science and Evaluation (BSE), Bristol Medical School, University of Bristol, Bristol, UKAcademic Respiratory Unit, University of Bristol, Bristol, UKVaccines Medical Affairs, Pfizer Ltd, Tadworth, UKVaccines Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, Pennsylvania, USA12 Vaccines Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, Pennsylvania, USAPopulation Health Sciences, University of Bristol, Bristol, UK9 Global Biopharmaceutical Business, Pfizer Inc, Collegeville, Pennsylvania, USABristol Vaccine Centre, Schools of Population Health Sciences and of Cellular and Molecular Medicine, University of Bristol, Bristol, UKObjectives To determine the disease burden of acute lower respiratory tract disease (aLRTD) and its subsets (pneumonia, lower respiratory tract infection (LRTI) and heart failure) in hospitalised adults in Bristol, UK.Setting Single-centre, secondary care hospital, Bristol, UK.Design We estimated aLRTD hospitalisations incidence in adults (≥18 years) in Bristol, UK, using two approaches. First, retrospective International Classification of Diseases 10th revision (ICD-10) code analysis (first five positions/hospitalisation) identified aLRTD events over a 12-month period (March 2018 to February 2019). Second, during a 21-day prospective review (19 August 2019 to 9 September 2019), aLRTD admissions were identified, categorised by diagnosis and subsequently annualised. Hospital catchment denominators were calculated using linked general practice and hospitalisation data, with each practice’s denominator contribution calculated based on practice population and per cent of the practices’ hospitalisations admitted to the study hospital.Participants Prospective review: 1322 adults screened; 410 identified with aLRTD. Retrospective review: 7727 adult admissions.Primary and secondary outcome measures The incidence of aLRTD and its subsets in the adult population of Southmead Hospital, Bristol UK.Results Based on ICD-10 code analysis, annual incidences per 100 000 population were: aLRTD, 1901; pneumonia, 591; LRTI, 739; heart failure, 402. aLRTD incidence was highest among those ≥65 years: 65–74 (3684 per 100 000 adults), 75–84 (6962 per 100 000 adults) and ≥85 (11 430 per 100 000 adults). During the prospective review, 410/1322 (31%) hospitalised adults had aLRTD signs/symptoms and annualised incidences closely replicated retrospective analysis results.Conclusions The aLRTD disease burden was high, increasing sharply with age. The aLRTD incidence is probably higher than estimated previously due to criteria specifying respiratory-specific symptoms or radiological change, usage of only the first diagnosis code and mismatch between case count sources and population denominators. This may have significant consequences for healthcare planning, including usage of current and future vaccinations against respiratory infection.https://bmjopen.bmj.com/content/12/6/e057464.full |
| spellingShingle | Jo Southern Adam Finn Catherine Hyams James Campling Bradford D Gessner Elizabeth Begier Maria Garcia Gonzalez Sharon Gray Jennifer Oliver Incidence of acute lower respiratory tract disease hospitalisations, including pneumonia, among adults in Bristol, UK, 2019, estimated using both a prospective and retrospective methodology BMJ Open |
| title | Incidence of acute lower respiratory tract disease hospitalisations, including pneumonia, among adults in Bristol, UK, 2019, estimated using both a prospective and retrospective methodology |
| title_full | Incidence of acute lower respiratory tract disease hospitalisations, including pneumonia, among adults in Bristol, UK, 2019, estimated using both a prospective and retrospective methodology |
| title_fullStr | Incidence of acute lower respiratory tract disease hospitalisations, including pneumonia, among adults in Bristol, UK, 2019, estimated using both a prospective and retrospective methodology |
| title_full_unstemmed | Incidence of acute lower respiratory tract disease hospitalisations, including pneumonia, among adults in Bristol, UK, 2019, estimated using both a prospective and retrospective methodology |
| title_short | Incidence of acute lower respiratory tract disease hospitalisations, including pneumonia, among adults in Bristol, UK, 2019, estimated using both a prospective and retrospective methodology |
| title_sort | incidence of acute lower respiratory tract disease hospitalisations including pneumonia among adults in bristol uk 2019 estimated using both a prospective and retrospective methodology |
| url | https://bmjopen.bmj.com/content/12/6/e057464.full |
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