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Promising fall in hospital deaths from pneumonia

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Improvements in hospital care for patients with pneumonia could be behind a drop in the number of deaths over the last six years, suggests new UK research.

The study, by Nottingham University Hospital NHS Trust and the British Thoracic Society, found hospital deaths from the most common form of pneumonia fell by 14% between 2009 and 2014.

“This fall in pneumonia deaths within 30 days of admission is very encouraging”

Wei Shen Lim

The findings, published in the journal Thorax, suggest key improvements in hospital care for community-acquired pneumonia – including earlier diagnosis and treatment – may be a contributing factor to the fall in death rate.

These included an 11.5% increase in the proportion of adults who got their first dose of antibiotics within four hours of being admitted to hospital.

There was also a 3.7% increase in the proportion who had a chest x-ray to confirm diagnosis within four hours. In addition, researchers found a 1.7% increase in the administration of appropriate antibiotics, in line with local guidelines.

The study authors analysed data from 23,315 UK admissions for community-acquired pneumonia to calculate the number of deaths within 30 days of arrival in hospital.

The 14% reduction in inpatient deaths happened despite no change in the severity of disease that patients were coming in with over the six years and the fact the average age of patients had risen.

“This fall in pneumonia deaths within 30 days of admission is very encouraging and suggests that local NHS hospitals have put in place measures to improve diagnosis, treatment and care,” said Professor Wei Shen Lim, consultant respiratory specialist at Nottingham University Hospitals.

National guidance on community-acquired pneumonia launched by the British Thoracic Society in 2009 have probably played a role in improving care, said the study authors.

New quality standards for the treatment of pneumonia published by the National Institute for Health and Care Excellence this year should help drive further improvements, they noted.

Under the new standards, adults with suspected pneumonia have should have a chest x-ray and get a diagnosis within four hours and those with the condition should start antibiotic therapy within the four-hour timeframe.

The study authors added: “To our knowledge, this is the largest UK study of temporal mortality trends in adults hospitalised with community-acquired pneumonia.”

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