Table 1.
Methodology and patient demographics of the studies included in the review. (Adapted from Supplementary Table 1 of Torres et al. [7], used under the Creative Commons—Attribution-NonCommercial (CC BY-NC 3.0) license. The original can be found here: http://thorax.bmj.com/content/suppl/2013/10/15/thoraxjnl-2013-204282.DC1/thoraxjnl-2013-204282supp_tables.pdf)
| Citation | Country; region | Study method | Study period | Population | Age (yrs [mean ± SD]) | Definition of CAP |
|---|---|---|---|---|---|---|
| Denmark | ||||||
| Holm et al. 2007 [65] | Denmark; Odense | Multicentre, prospective, observational study | 9 Sept–1 Nov 2002; 6 Jan–25 April 2003 | Primary care patients ≥18 yrs with a diagnosis of community-acquired LRTI, n = 364; 48 with pneumonia | Overall, median 50 [range 18–94] | GP diagnosis of LRTI and chest X-ray confirmed |
| Pneumonia, median 61 [range 22–88] | ||||||
| France | ||||||
| Le Moing et al. 2006 [35] | France; national | Multicentre, prospective, observational cohort study | May 1997–Dec 2001 | HIV patients receiving protease inhibitor therapy, n = 1,203; 29 hospitalised with pneumonia | Median 36 | Clinical symptoms, chest X-ray confirmed and microbiological data |
| Bénard et al. 2010 [33] | France; Aquitaine | Multicentre, prospective, cohort study | 2000–2007 | Patients with HIV, n = 3,336; 135 with bacterial pneumonia | Median 39.6 [IQR 34.5–46.0] | Chest X-ray confirmed and bacteriological identification or successful antibacterial treatment |
| Chidiac et al. 2012 [27] | France; metropolitan | Multicentre, prospective, observational, cohort study | 1 April 2006–30 June 2007 | Patients hospitalised with community-acquired Legionnaires’ disease, n = 540 | 60 [range 17–100] | Chest X-ray confirmed and laboratory evidence of Legionella pneumophila infection |
| Germany | ||||||
| Klapdor et al. 2012 [41] | Germany; national (CAPNETZ) | Multicentre, prospective, observational study | Jan 2002–June 2009 | Patients ≥18 yrs with CAP, n = 7,803; 4,083 <65 yrs (2.6 % nursing home residents); 3,720 ≥65 yrs (14.4 % nursing home residents) | Overall, 60.9 ± 18.5 [range 18–101] | Clinical symptoms, chest X-ray confirmed and microbiological data |
| <65 yrs, median 47.0 [IQR 20.7] | ||||||
| ≥65 yrs, median 76.0 [IQR 11.8] | ||||||
| von Baum et al. 2010 [32] | Germany; national (CAPNETZ) | Multicentre, prospective, observational study | 1 June 2002–30 June 2007 | Patients with CAP, n = 5,130 (6 % nursing home residents); 67 with EB; 22 with PA; 1,833 with no definite EB/PA | Overall, 60 ± 18 | Chest X-ray or clinical symptoms |
| With EB, 73 ± 15 | ||||||
| With PA, 64 ± 17 | ||||||
| No EB/PA, 58 ± 18 | ||||||
| Kothe et al. 2008 [23] | Germany; national (CAPNETZ) | Multicentre, prospective, observational study | March 2003–Oct 2005 | Patients with CAP, n = 2,647; 1,298 <65 yrs (3.3 % nursing home residents); 1,349 ≥65 yrs (15.2 % nursing home residents) | <65 yrs, 47.2 ± 12.7 | Clinical symptoms, chest X-ray confirmed and microbiological data |
| ≥65 yrs, 77.1 ± 7.5 | ||||||
| Greece | ||||||
| Kofteridis et al. 2009 [30] | Greece; Crete | Single-centre, retrospective, observational study | Jan 1996–Dec 2002 | Adults hospitalised with community-acquired LRTI due to Haemophilus influenzae n = 45 | Median 68 [range 28–86] | Clinical symptoms, chest X-ray confirmed and positive sputum culture for H. influenzae |
| Italy | ||||||
| Madeddu et al. 2008 [36] | Italy; northern Sardinia | Single-centre, observational, retrospective analysis of consecutive patients | Jan 1999–Dec 2004 | HIV patients hospitalised with CAP, n = 76; 84 episodes | 38.3 ± 7.5 [range 27–80] | Clinical symptoms, chest X-ray confirmed and microbiological data |
| aViegi et al. 2006 [47] | Italy, national | Multicentre, prospective, observational, population-based study | 15 Feb 1999–14 Feb 2000 | Primary care patients with CAP, n = 699; 548 diagnosed by GP (4.7 % nursing home residents); 151 diagnosed by hospital (8.9 % nursing home residents) | 59.6 ± 19.5 | Chest X-ray and clinical symptoms |
| Patients diagnosed in community, 57.6 ± 19.2 | ||||||
| Patients diagnosed in hospital, 66.7 ± 18.7 | ||||||
| bManno et al. 2009 [37] | Italy; Brescia | Single-centre, prospective, observational, cohort study | June 2000–Dec 2006 | HIV patients hospitalised with CAP | Cirrhosis, 41.0 ± 4.3 | Clinical symptoms, chest X-ray confirmed and microbiological data |
| Patients with cirrhosis, n = 29 | No cirrhosis, 37.3 ± 6.2 | |||||
| Patients without cirrhosis, n = 73 | ||||||
| Migliorati et al. 2006 [66] | Italy; Brescia | Single-centre, observational, retrospective analysis | Jan 2001–Dec 2002 | Patients ≥15 yrs hospitalised with discharge diagnosis of pneumonia or pneumonia-related disease, n = 148 (20 % nursing home residents) | 70.3 ± 17.3 | Chest X-ray confirmed |
| Spain | ||||||
| Sopena et al. 2007 [28] | Spain; Barcelona | Single-centre, prospective, observational, cohort study | 1994–2004 | Adult patients hospitalised with community-acquired Legionnaires’ disease, n = 251; 138 sporadic cases; 113 outbreak cases | Sporadic cases, 56.6 ± 15.5 | Laboratory evidence of acute infection with L. pneumophila |
| Outbreak cases, 59.5 ± 16.6 | ||||||
| Sopena et al. 2007 [29] | Spain; Barcelona | Single-centre, retrospective, observational, cohort study | 1994–2004 | Patients hospitalised with CAP due to L. pneumophila, n = 158; 104 <65 yrs; 54 ≥65 yrs | <65, 65.9 % of cohort | Laboratory evidence of infection with L. pneumophila |
| ≥65, 34.1 % | ||||||
| ≥70, 13.9 % | ||||||
| ≥85, 1.9 % | ||||||
| Garcia-Vidal et al. 2009 [48] | Spain; Barcelona | Single-centre, prospective, observational cohort study | 1 Jan 1995–31 Dec 2005 | Patients hospitalised with CAP, n = 1,556; 146 with recurrent CAP (≥2 episodes of CAP in 3 yrs with asymptomatic period ≥1 month); 1,410 with non-recurrent CAP | Recurrent CAP, 70.96 ± 13.824 | Clinical symptoms, chest X-ray confirmed and microbiological data |
| Non-recurrent CAP, 65.03 ± 16.573 | ||||||
| Falguera et al. 2009 [39] | Spain; Catalonia | Two-centre, prospective, observational cohort study | Jan 1995–Dec 2005 | Patients ≥18 yrs hospitalised with CAP, n = 3,272; 61 with Gram-negative infections; 3,211 with non-Gram-negative infections | 64 [range 18–100] | Clinical symptoms, chest X-ray confirmed and microbiological data |
| Gram-negative infections, 69 | ||||||
| Non-Gram-negative infections, 63 | ||||||
| Ruiz et al. 2010 [31] | Spain; Basque country | Single-centre, prospective, observational, cohort study | Jan 1995–Dec 2007 | Adults hospitalised with bacteraemic CAP due to Gram-negative bacteria, n = 51 | 72.9 ± 11.3 | Clinical symptoms, chest X-ray confirmed |
| Viasus et al. 2011 [46] | Spain; Barcelona | Single-centre, prospective, observational, cohort study | 13 Feb 1995–31 Dec 2008 | Patients with and without cirrhosis, hospitalised with CAP, n = 3,420; 90 with cirrhosis; 3,330 with no cirrhosis | Cirrhosis, 61.8 ± 13.0 | Chest X-ray and clinical symptoms |
| No cirrhosis, 66.8 ± 16.9 | ||||||
| Viasus et al. 2011 [50] | Spain; Barcelona | Single-centre, prospective, observational, cohort study | 13 Feb 1995–30 April 2010 | Adult patients with and without chronic renal disease, hospitalised with CAP, n = 3,800; 203 with renal disease (8.6 % nursing home residents); 3,597 with no renal disease (8.1 % nursing home residents) | Renal disease, median 77 [IQR 67–84] | Chest X-ray, clinical symptoms and microbiological data |
| No renal disease, median 70 [IQR 56–79] | ||||||
| de Roux et al. 2006 [45] | Spain; Barcelona | Single-centre, prospective, observational cohort study | Oct 1996–Nov 2001 | Patients hospitalised with CAP, classified according to alcohol abuse status | Current alcohol abuse, 58 ± 14 | Clinical symptoms, chest X-ray confirmed and microbiological data |
| Current, n = 128 | Former alcohol abuse, 71 ± 11 | |||||
| Former, n = 54 | No alcohol abuse, 68 ± 19 | |||||
| None, n = 1,165 | ||||||
| Gutiérrez et al. 2005 [40] | Spain; Alicante | Single-centre, prospective, observational, cohort study | 15 Oct 1999–14 Oct 2001 | Patients ≥15 yrs with CAP, n = 493 | 56.6 [range 15–94] | Clinical symptoms, chest X-ray confirmed and microbiological data |
| Curran et al. 2008 [34] | Spain; Barcelona | Single-centre, prospective, observational cohort study | Jan 2000–Dec 2005 | HIV patients ≥18 yrs hospitalised with bacterial pneumonia, n = 161; 186 episodes | 39.7 ± 7.8 | Clinical symptoms, chest X-ray confirmed and response to antibacterial therapy |
| Pérez-Sola et al. 2011 [67] | Spain; national | Multicentre, prospective, observational, cohort study | Feb 2000–Jan 2006 | Patients with rheumatic diseases treated with TNF antagonists, n = 6,969; 101 with pneumonia | 50 ± 14 | CDC criteria |
| Carratalà et al. 2007 [43] | Spain; Barcelona | Single-centre, prospective, observational study | 1 Jan 2001–31 Dec 2004 | Adult patients with CAP requiring hospitalisation, n = 601 | 63.7 ± 17.1 | Chest X-ray confirmed |
| Cabre et al. 2010 [25] | Spain; Mataró | Single-centre, prospective, observational study | Jan 2001–Aug 2005 | Patients ≥70 yrs with CAP requiring hospitalisation, n = 134 (32 % nursing home residents) | 84.51 ± 6.8 | Chest X-ray confirmed |
| Cillóniz et al. 2012 [44] | Spain; Barcelona | Single-centre, prospective, observational cohort study | 2001–2009 | Adult patients hospitalised with pneumococcal pneumonia, n = 626 | 63.6 ± 18.9 | Clinical symptoms, chest X-ray confirmed and microbiological data |
| 46 % ≤65 yrs | ||||||
| Vila-Corcoles et al. 2009 [26] | Spain; Tarragona | Multicentre, prospective, observational, population-based, cohort study | 1 Jan 2002–30 April 2005 | Community-dwelling individuals ≥65 yrs, n = 11,241 | 65–74, 55.2 % of cohort | Chest X-ray and clinical symptoms |
| 75–84, 34.3 % | ||||||
| ≥85, 10.5 % | ||||||
| Cillóniz et al. 2011 [22] | Spain; Barcelona | Single-centre, prospective, observational cohort study | Jan 2003–Dec 2010 | Patients with CAP admitted to ICU, n = 362 | 63.4 ± 16.5 | Chest X-ray confirmed |
| Molinos et al. 2009 [38] | Spain; Asturias | Multicentre, prospective, observational study | April 2003–April 2004 | Patients hospitalised with CAP, n = 710; 244 with COPD; 466 no COPD (5 % nursing home residents in both groups) | Overall, 67.14 [95 % CI 65.9–68.4] | Clinical symptoms, chest X-ray confirmed and microbiological data |
| With COPD, 73.7 [95 % CI 72.5–74.9] | ||||||
| No COPD, 63.6 [95 % CI 61.8–65.4] | ||||||
| Liapikou et al. 2012 [42] | Spain; Barcelona | Single-centre, prospective, observational cohort study | 2004–2008 | Adult patients hospitalised with CAP, n = 1,379; 212 with COPD (5.7 % nursing home residents); 1,167 no COPD (10.2 % nursing home residents) | Overall, 70 ± 17 | Clinical symptoms, chest X-ray confirmed and microbiological data |
| COPD, 73.4 ± 8.8 | ||||||
| No COPD, 69.4 ± 17.9 | ||||||
| Almirall et al. 2013 [24] | Spain; Mataró | Single-centre, prospective, observational, case–control study | Feb 2008–Feb 2010 | Patients ≥70 yrs with CAP requiring hospitalisation | Cases, mean ± SEM 81.22 ± 0.77 | Chest X-ray confirmed and bacteriological identification |
| Cases, n = 36 | Controls, mean ± SEM 81.21 ± 0.53 | |||||
| Controls, n = 72 | ||||||
| Giannella et al. 2012 [49] | Spain; national | Multicentre, prospective, observational cohort study | Jan and June 2010 (1 week in each month) | Patients ≥16 yrs treated for CAP in the internal medicine department, n = 591 | Median 77 [IQR 65–84] | Clinical symptoms, chest X-ray confirmed |
| UK | ||||||
| Bewick et al. 2012 [68] | UK; Nottingham | Two-centre, prospective, observational cohort study | Sept 2008–Sept 2010 | Patients ≥16 yrs hospitalised with CAP, n = 920 (5.5 % nursing home residents); 366 with pneumococcal pneumonia (6.8 % nursing home residents) | Median 71.7 [IQR 57.8–80.8] | Chest X-ray confirmed |
CAP community-acquired pneumonia; CAPNETZ Competence Network for Community-Acquired Pneumonia; CDC Centers for Disease Control and Prevention; COPD chronic obstructive pulmonary disease; EB Enterobacteriaceae; GP general practitioner; HIV human immunodeficiency virus; ICU intensive care unit; IQR interquartile range; LRTI lower respiratory tract infection; PA Pseudomonas aeruginosa; SD standard deviation; SEM standard error of the mean; TNF tumour necrosis factor; yrs years
aTen patients in this study were aged ≤14 yrs
bThis paper refers to patients with cirrhosis as ‘Cases’ and those without cirrhosis as ‘Controls’. However, there is no evidence of any matching of ‘cases’ and ‘controls’