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© 2004 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim
P2.45: Risk factors for recurrent community acquired pneumonia: first results of the
CAP-Network
Andreas Walter*, Miriam Schwartz, Y. Kohlhammer, Heiner Raspe, Torsten Schäfer
* Corresponding Author: Institute of Social Medicine, Medical University Schleswig-Holstein, Campus Luebeck email: [email protected]
CAPNET (Community Acquired Pneumonia NETwork) was established as one of the competence networks funded by the Federal Ministry of Education and Research in 2002. The central project Z2 covers areas of epidemiology, data management and statistics and health services research. Only few epidemiological studies have analysed risk factors for CAP and even less information is available on parameters which are associated with an increased risk of CAP recurrency. Therefore the aim of this analysis was to identify predictors of recurrent CAP. A standardised questionnaire was distributed to patients who were recruited in the CAPNet between November 2002 and October 2003. The instrument covers questions on the medical history, potential risk factors and the vaccination status. Patients who devel-oped CAP for the first time were compared to those with recurrent CAP in a case-control approach. The data of 302 patients with an average age of 55 years (SD 18, 18-95) were analysed (46% female). Of these 121 (38.5%) gave a history of at least one prior CAP. After control for age, sex, and smoking status, a history of a chronic lung disease (OR 2.0, 1.2-3.5) and difficulties to swallow (OR 4.1, 1.6-10.6) remained statistically significant risk factors for CAP recurrency in a logistic regression model. The risk factors identified for CAP seem not to be identical with risk factors of CAP recurrency. The consideration of these specific medical conditions may help to decrease the risk of CAP recurrences.
P2.46: Predictors for the need of inpatient care in patients with community acquired
pneumonia: first results of the CAP-Network
Andreas Walter*, Miriam Schwartz, Y. Kohlhammer, Tom Schaberg, Heiner Raspe, Torsten Schäfer
* Corresponding Author: Institute of Social Medicine, Medical University Schleswig-Holstein, Campus Luebeck email: [email protected]
CAPNET (Community Acquired Pneumonia NETwork) was established as one of the competence networks funded by the Federal Ministry of Education and Research in 2002. Thereby the central project Z2 covers areas of epidemiology, data management and statistics and health services research. Although this infection is required in the community by definition about 30% of the cases develop a need for hospitalisation ac-cording to international studies. Little, however, is known on factors which would predict the need for inpatient care of CAP-patients. The knowledge of these factors would allow to pay special attention to patients at risk. This analysis comprised 807 CAP-patients, who had been recruited by the eight clinical CAPNet centres between July 2002 and October 2003. Data concerning medical treatment and risk factors were obtained by a standardised questionnaire. Finally the data of 470 men (58%) and 337 women (42%) with an average age of 61 years (SD 18, 18-98) were analysed. A total of 600 (74.3%) patients were treated as inpatients during their disease period. After controlling for smoking status and a history of chronic lung disease in logistic regression, female gender (OR 0.65, 0.45-0.93) and an actual influenza vaccination (OR 0.65, 0.44-0.96) proved to have a preventive effect on the need for hospitalisation whereas patients over 60 years of age were at increased risk (OR 1.76, 1.21-2.58). The percentage of hospital admissions (74.3%) is high compared to reports from the international literature (15-50%). Based on these differences it should be analysed in how far the need for hospitalisation approximates the case severity. The data suggest that an actual influenza vaccination decreases the need for hospitalisation due to CAP.
