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Significant fall in hospital deaths from pneumonia

But respiratory specialists warn against complacency as UK death rate is third highest in Europe

Ingrid Torjesen

Friday, 19 August 2016

Hospital deaths from the most common form of pneumonia decreased in the UK by 14% between 2009 and 2015, according to research* published online in Thorax, the journal of the British Thoracic Society (BTS.)

The researchers from the Department of Respiratory Medicine, Nottingham University Hospital’s NHS Trust and the British Thoracic Society analysed data from 23,315 UK hospital admissions for community acquired pneumonia (CAP) across six years and attributed the fall to the improvement of key elements of hospital care for CAP between 2009 and 2015.

These improvements included an 11.5% increase in the proportion of adults who received their first dose of antibiotics within four hours of being admitted to hospital, a 3.7% increase in the proportion of adults who had a chest x-ray to help confirm the diagnosis within four hours of being admitted to hospital and a 1.7% increase in the administration of appropriate antibiotics, in line with local guidelines.

The reduction in inpatient deaths, which occurred within 30 days of hospital admission, happened despite there being no change in the severity of the disease when the patient was admitted and the average age of the patient actually increasing over the six years studied.

Lung specialists have pointed to the probable role of guidelines, from the British Thoracic Society and NICE, in helping drive these improvements. But they have also warned against complacency as the death rate in the UK from pneumonia is the third highest in Europe.

Professor Wei Shen Lim, consultant respiratory specialist at Nottingham University Hospitals NHS Trust and member of the British Thoracic Society, said: “This fall in pneumonia deaths within 30 days of admission to hospital is very encouraging and suggests that local NHS hospitals have put in place measures to improve diagnosis, treatment and care. We hope that improvements continue to be made and that the new ‘Quality Standard’ from NICE accelerates this process.”

Dr Lisa Davies, Consultant Respiratory Physician, University Hospital Aintree NHS Foundation Trust, Liverpool and Chair of the British Thoracic Society’s Board, said:  “This research is really encouraging and shows that if NHS hospitals put in place simple steps, they have the power to save lives from pneumonia. Looking wider, we also need a systematic approach in the community to prevent pneumonia happening in the first place and help speed up diagnosis. This should involve patient education for at risk groups about the need to tackle winter illnesses early before they escalate, targeted vaccination, and national guidance being implemented in the community on the first steps to diagnosing the disease.”

* Daniel P, et al. Mortality reduction in adult community-acquired pneumonia in the UK (2009–2014): results from the British Thoracic Society audit programme. Thorax, published online first 17 August 2016. doi:10.1136/thoraxjnl-2016-208937

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