Adults Hospitalized with Pneumonia in the United States: Incidence, Epidemiology and Mortality

Understanding the burden of community-acquired pneumonia (CAP) is critical to allocate resources for prevention, management, and research. The objectives of this study were to define incidence, epidemiology, and mortality of adult patients hospitalized with CAP in the city of Louisville, and to estimate burden of CAP in the United States (U.S.) adult population. This was a prospective population-based cohort study of adult residents in Louisville, Kentucky from June 1, 2014 to May 31, 2016. Hospitalized patients with CAP were enrolled at all adult hospitals in Louisville. The annual population-based CAP incidence was calculated. Geospatial epidemiology was used to define ecological associations among CAP and income level, race, and age. Mortality was evaluated during hospitalization, at 30-days, 6-months, and 1-year after hospitalization. During the 2-year study, from a Louisville population of 587,499 adults, 186,384 hospitalizations occurred. A total of 7,449 unique patients hospitalized with CAP were documented. The annual age-adjusted incidence was 649 patients hospitalized with CAP per 100,000 adults (95% CI=628.2–669.8), corresponding to 1,591,825 annual adult CAP hospitalizations in the U.S. Clusters of CAP cases were found in areas with low-income and Black/African American populations. Mortality during hospitalization was 6.5%, corresponding to 102,821 annual deaths in the U.S. Mortality at 30-days, 6-months, and 1-year was 13.0%, 23.4%, and 30.6%, respectively. The estimated US burden of CAP is substantial, with more than 1.5 million unique adults being hospitalized annually, 100,000 deaths occurring during hospitalization, and approximately 1 out of 3 patients hospitalized with CAP dying within 1-year. All authors: No reported disclosures.