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Community-acquired pneumonia death rates halved over past decade

Hospital deaths down from 20% in 2009 to 10% in 2019, but readmissions and admissions to emergency care still rising

Caroline White

Friday, 06 December 2019

Death rates from community-acquired pneumonia (CAP) in NHS hospitals across the UK have nearly halved over the past decade, reveal new figures released at the British Thoracic Society (BTS) Winter Meeting this week.

But readmissions for CAP and admissions via emergency care, have continued to rise, the figures show.

The annual incidence of CAP is 500–1100 per 100,000 of the adult population.

The report*, which audited the treatment and management of patients with CAP in 154 hospitals, found that death rates had fallen from 20.2% in 2009 to 10.4% in 2019.

More patients are now receiving faster and evidence-based management of the disease, with most hospitals hitting BTS ‘time targets’ for delivering vital medical treatment (the BTS ‘CAP care bundle’) that patients need on admission.

The data showed that in three out of four cases (74.4%) patients were given their first dose of antibiotics within the national target of four hours of admission in 2018-19 compared with 60% in 2009-10. 

In over half of cases (58%) patients received antibiotics recommended in national guidance. This compares with 54% in 2009-10, and in 85% of cases patients had a chest x-ray within four hours of admission. 

The audit also showed that antibiotics were given more quickly to patients on arrival in hospital and that the number of senior medical reviews given within 12 hours increased. 

“These are examples of treatment improvements which will make a profound difference to patient outcomes,” commented report author Professor Wei Shen Lim, of Nottingham University Hospitals.

The BTS audit, which collected data from 10,196 patient records from 154 participating institutions across the UK between 1 December 2018 and 31 January 2019, nevertheless highlighted areas of concern.

Hospital re-admissions for CAP within 30 days rose. These have risen over the course of the past three audits; and now occur in more than 14% of cases.

And hospital admissions via the emergency department have also continued to increase, and now make up 85% of such cases.

“There are many positives in this audit including faster provision of medication, faster x-rays and timely, higher levels of senior review,” commented Professor Lim.

“However, one area for improvement centres on the need to reduce the high volume of patients still arriving at hospital emergency departments with pneumonia. Hospital care is really improving, but we need to prevent and manage the condition better in the community to avoid people needing a visit to hospital.

“This will require a more integrated approach between NHS hospitals, GPs and community care – sharing expertise, knowledge and best practice.” 

*Lim WS and Lawrence H. National Audit Report: Adult Community Acquired Pneumonia Audit 2018-2019. British Thoracic Society, November 2019.  

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