Risk factors prevalence in adult community acquired pneumonia in primary care in Spain (NEUMO-ES-RISK project).

Background & Aim: Several lifestyle factors and comorbidities have been linked to an increased risk for Community-acquired pneumonia (CAP), although their prevalence has not been well documented. The aim of this study is to assess the prevalence and distribution of risk factors in primary care CAP.

Method: Retrospective observational study in adults with CAP at primary care in Spain between 2009-2013, using the National Surveillance System of Primary Care Data (BiFAP).

Results: 28.413 patients. Mean age (standard deviation): 60.5(20.3) years. 51.7% males. Average prevalence of comorbidities was 71.3%, which increased with age, doubling the risk in males by the age of 75(females 20% vs males 40%). From 55 years of age at least one risk factor (RF) was identified in 85.7% of cases: 1 RF(23.8%), 2RF(23.4%), 3 or more RF(38.5%). Major risk factors were: metabolic disease(27.4%), cardiovascular disease(17.8%) and diabetes(15.5%). According to gender: a) women= metabolic diseases(26.9%), depression(20.0%), anemia(15.8%); b) men= metabolic disease (27.8%), cardiovascular disease (20.5%), diabetes (17.9%). According to age: a) 18-25 years= poor dental hygiene(9.1%), smoking(8.0%), asthma(7.8%); b) 25-40 years= smoking(13.5%), poor dental hygiene(10.0%), anemia(7.1%); c) 40-55= smoking(20.9%), metabolic disease(17.7%), depression(12.0%); d) 55-70 years= metabolic disease(40.4%), smoking(18.3%), diabetes (17.9%); e) 70-85 years= metabolic disease(41.5%), cardiovascular disease(33.0%), diabetes(28.9%); and f) over 85 years= cardiovascular disease(39.3%), metabolic disease(27.5%), anemia(25.6%).

Conclusions: Prevalence of risk factors in adult CAP in primary care in Spain is high. Main risk factors associated are cardiovascular disease, metabolic disease and diabetes. CAP risk increases with age and doubles in males older than 75 years. Majority of CAP cases beyond 55 years of age associate at least 1 risk factor.

Keywords: Community acquired pneumonia, risk factors, Primary care

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