Community-acquired Pneumonia in Buskerud County in Norway

Community-acquired Pneumonia: A Prospective Observational Study to Explore Etiology, Risk Factors and Potential Predictors for re- Admittance to Hospital and All-cause Mortality

The purpose of this study is to determine the etiology of community-acquired pneumonia, to assess risk factors and to investigate potential prognostic biomarkers of serious disease and fatal outcome.

Study Overview

• Status: Completed
• Conditions: Pneumonia; Community-Acquired Infections

Detailed Description

Background: This project addresses an important challenge in international medicine: Pneumonia as the leading cause of death from infection in developed countries. Purpose: (A) Determine the etiology of CAP among adult hospitalized patients- especially the occurrence of mixed infections- by systematic implementation of combined conventional and new diagnostic methods. (B) Assess risk factors of CAP, such as COPD, congestive heart failure, smoking, malignancy etc., predictive of re-admittance to hospital and mortality. (C) Examine the prognostic value of potential predictors in relation to all-cause mortality in adult patients hospitalized with CAP. Design: Prospective observational study with inclusion of 270 adult patients during a 3-year period, who all required admission for pneumonia in a community hospital setting. Clinical and biochemical data was recorded longitudinally by inclusion, at stable clinical situation and after 6 weeks, and mortality and need for re-admission within 12 months. Patients were examined systematically, using modern research methods to explore relevant microbes. At all points, blood tests were sampled for clinical-chemical analysis, DNA, RNA and immunological analyses. Application: A translational research approach with the ambitions to elucidate new pathogenic mechanisms which could lead to new diagnostic tools and treatment modalities. This will possibly lead to less drug exposure and unnecessary hospitalization both of which have positive consequences for patients and medical care costs.

• Study Type: Observational
• Enrollment (Actual): 270

Contacts and Locations

Study Locations

• Norway
  • Buskerud
    • Drammen, Buskerud, Norway, 3004
      • Vestre Viken Hospital Trust

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

All adult patients with CAP admittet to Vestre Viken HF-Buskerud Hospital (VVHF-BH) between January 2008 og January 2011, were evaluated for inclusion in the study.

Description

Inclusion Criteria:

• New infiltrate on chest X-ray and

• Fever > 38,0 by rectal measurement

  • at least one of these additional criteria: Cough +/- expectoration, dyspnoea, respiratory chest pain, crackles or reduced respiratory sounds.
• Criteria must be present within 48 hours after admission

Exclusion Criteria:

• Patients < 18 years
• Non infectious cause of lung infiltration (tumors, embolism)
• Bronchial obstruction (tumor, bronchiectasia)
• Hospitalised more than 48 hours or discharged within the last 2 weeks

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Adults with CAP admitted to hospital; All adult patients with CAP admitted to Vestre Viken HF-Buskerud Hospital (VVHF-BH), a 400-bed community general hospital, between January 2008 og January 2011 were evaluated for inclusion in the study.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
all cause mortality	one year

Secondary Outcome Measures

Outcome Measure	Time Frame
Re-admission to hospital	One month

Collaborators and Investigators

• Sponsor: Vestre Viken Hospital Trust
• Collaborators: Oslo University Hospital; Vestre Viken HF - Buskerud Hospital; UMass Medical school, Massachusetts - USA
• Investigators: Study Director: Lars Heggelund, MD, PhD, Vestre Viken Hospital Trust and Oslo University Hospital; Study Chair: Einar Husebye, MD, PhD, Vestre Viken Hospital Trust; Principal Investigator: Jan C Holter, MD, Vestre Viken Hospital Trust

Publications and helpful links

General Publications

• Holter JC, Muller F, Bjorang O, Samdal HH, Marthinsen JB, Jenum PA, Ueland T, Froland SS, Aukrust P, Husebye E, Heggelund L. Etiology of community-acquired pneumonia and diagnostic yields of microbiological methods: a 3-year prospective study in Norway. BMC Infect Dis. 2015 Feb 15;15:64. doi: 10.1186/s12879-015-0803-5.

Study record dates

Study Major Dates

• Study Start: January 1, 2008
• Primary Completion (Actual): January 1, 2011
• Study Completion (Actual): January 1, 2012

Study Registration Dates

• First Submitted: March 22, 2012
• First Submitted That Met QC Criteria: March 23, 2012
• First Posted (Estimate): March 26, 2012

Study Record Updates

• Last Update Posted (Estimate): March 26, 2012
• Last Update Submitted That Met QC Criteria: March 23, 2012
• Last Verified: March 1, 2012

More Information

Terms related to this study

• Keywords: Prognosis; Prospective Studies; Community-Acquired Infections; Pneumonia/microbiology; Pneumonia/diagnosis
• Additional Relevant MeSH Terms: Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Lung Diseases; Pneumonia; Community-Acquired Infections
• Other Study ID Numbers: REK:S-06266a