Program Schedule

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Cost of Treating Patients with Pneumococcal Community-Acquired Pneumonia (CAP) in French Hospitals: Interim Results of the Prospective PNEUMOCOST Study

Session: Poster Abstract Session: Clinical Respiratory Infections
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC

Background:

Documenting the economic burden of CAP is essential to define efficient  vaccination strategies. PNEUMOCOST study was designed to estimate the cost of treatment in the French context. 

Methods:

A prospective, multi-centric, observational study including patients hospitalized for a pneumococcal CAP involved 40 centers. Five hundred and fifty patients were expected to be enrolled from Oct 2011 to April 2014. All enrolled patients are followed over a 6 month period. Interim results on patients' profiles and initial hospitalization are presented. Inclusion criteria: adult age >18, CAP confirmed at admission by X-ray, S. pneumoniae confirmed with microbiological sampling. Informed consent was required. Exclusion criteria: pregnancy, patients included in clinical trials, patients with prior 48 h admission for another cause, patients unable to answer to follow-up questionnaire over six months. 

Results:

Patients characteristics: 455 patients with validated clinical data; 54.6% of patients were men, average age 63 years (Min: 19; Max: 96); 77.3% of patients were 50 +. S. pneumoniae was identified through urinary antigen detection (UAD) alone in 44% of cases; altogether, 73.4% UAD were performed, blood cultures in 37.4%, other tests were mainly sputum culture. Table 1 displays antibiotic sensitivity.

Average length of stay (LOS) was 13.8 days (SD 14.8). LOS increased with the Charlson score, from 10.5 days for score 0 to 17.4 for scores ≥6.  Rate of admission in a resuscitation unit increased with the Port score, from 14% for Class 1 to 49% to Class 4. Surprisingly, inpatient mortality rate was low (1.8%; n=8 patients).  Average cost of stay from a payer's  perspective was € 6,962 (SD € 6,933). The distribution of cost was skewed: 25% of stays represented 56% of total costs of all stays.  

Conclusion:

PNEUMOCOST is the largest French cohort of patients hospitalized for pneumococcal CAP to date.  Initial results confirm the high economic impact of the disease.  Follow-up data should increase this burden.

Charlson and Port scores of enrolled patients are displayed in Graphs 1 & 2.

Christian Chidiac, MD1, Henri Laurichesse, MD, PhD2, Gabrielle Illes, MD3, Jacques Gaillat, MD4, Pierre Bonnin, MD5, Jean-Damien Ricard, MD, PhD6, Jonathan Messika, MD6, Bruno Detournay, MD, MBA7, Grèce Saba, PharmD, Msc8, Patrick Petitpretz, MD9 and Gérard De Pouvourville, PhD8, (1)Inserm U851, UCBL1, Hospices Civils de Lyon, Lyon, France, (2)Maladies Infectieuses, CHU de Clermont-Ferrand, Clermont-Ferrand, France, (3)Maladies Infectieuses Et Tropicales, CHU Brabois, Vandoeuvre-lès-Nancy, France, (4)Annecy Hospital, Annecy, France, (5)Infectious Diseases, Centre Hospitalier Annecy Genevois, Metz Tessy BP 90074, France, (6)Réanimation Médico-Chirurgicale, Hôpital Louis Mourier, Colombes, France, (7)CEMKA-EVAL, Bourg-la-Reine, France, (8)Chair of Health Systems, ESSEC Business School, Cergy-Pontoise, France, (9)Maladies Infectieuses Et Tropicales, Hôpital André Mignot, Versailles, France

Disclosures:

C. Chidiac, Pfizer: Board Member, Consulting fee

H. Laurichesse, Pfizer: Board Member, Consulting fee

G. Illes, None

J. Gaillat, Pfizer: Board Member, Consulting fee

P. Bonnin, None

J. D. Ricard, None

J. Messika, None

B. Detournay, None

G. Saba, None

P. Petitpretz, Pfizer: Board Member, Consulting fee

G. De Pouvourville, Pfizer: Board Member, Consultant and Grant Investigator, Consulting fee and Research grant

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