title: Outcomes in elderly Danish citizens admitted with community-acquired pneumonia. Regional differencties, in a public healthcare system.
abstract: OBJECTIVE
  To evaluate regional differences in and risk factors for admission, length of stay, mortality, and readmission for community-acquired pneumonia in elderly Danish patients.
  
  
  METHODS
  National registry study on elderly Danish citizens with an acute admission in 2009 owing to community-acquired pneumonia. We studied differences among hospitals in length of stay, in-hospital mortality, mortality within 30 days of discharge, and readmission within 30 days after discharge using Cox regression models with adjustments for age, sex, ventilatory support, and co-morbidity by Charlson's index score.
  
  
  RESULTS
  A total of 11,332 elderly citizens were admitted with community-acquired pneumonia. Mortality during admission and 30-days from discharge were 11.6% and 16.2%, respectively. Readmission rates within 30 days of discharge were 12.3%. There were significantly differences between hospitals in length of stay. A high Charlson index score and advanced age were significantly risk factors for death during admission and within 30 days of discharge. Male sex and high Charlson index score were significant risk factors for readmission. Admission to large bed capacity hospital was a significant risk factor for death and readmission within 30 days of discharge.
  
  
  CONCLUSIONS
  Length of stay, rate of admission, mortality and readmission in elderly Danish patients with community-acquired pneumonia follows international findings. There are regional differences between hospitals. In depth investigation in regional differences could reveal potential feasible clinical interventions with an improvement of readmission-, mortality rates and cost.
authors.affiliation: Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Kettegård Allé 30, 2650 Hvidovre, Denmark. henrik.hedegaard.klausen@regionh.dk
authors.forename: H H
authors.initials: HH
authors.lastname: Klausen
authors.forename: J
authors.initials: J
authors.lastname: Petersen
authors.forename: T
authors.initials: T
authors.lastname: Lindhardt
authors.forename: T
authors.initials: T
authors.lastname: Bandholm
authors.forename: C
authors.initials: C
authors.lastname: Hendriksen
authors.forename: H
authors.initials: H
authors.lastname: Kehlet
authors.forename: J
authors.initials: J
authors.lastname: Vestbo
authors.forename: O
authors.initials: O
authors.lastname: Andersen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000401:mortality / Q000628:therapy; D003718:Denmark / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D010359:Patient Readmission; D011014:Pneumonia / Q000401:mortality* / Q000628:therapy; D012111:Residence Characteristics; D012121:Respiration, Artificial / Q000401:mortality; D012307:Risk Factors