{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T01:53:32Z","timestamp":1779328412777,"version":"3.51.4"},"reference-count":27,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T00:00:00Z","timestamp":1655251200000},"content-version":"unspecified","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pfizer, Inc","award":["WI255886-1"],"award-info":[{"award-number":["WI255886-1"]}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"crossref","award":["ACF-2015-25-002"],"award-info":[{"award-number":["ACF-2015-25-002"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,6,6]]},"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the disease burden of acute lower respiratory tract disease (aLRTD) and its subsets (pneumonia, lower respiratory tract infection (LRTI) and heart failure) in hospitalised adults in Bristol, UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single-centre, secondary care hospital, Bristol, UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We estimated aLRTD hospitalisations incidence in adults (\u226518 years) in Bristol, UK, using two approaches. First, retrospective International Classification of Diseases 10th revision (ICD-10) code analysis (first five positions\/hospitalisation) identified aLRTD events over a 12-month period (March 2018 to February 2019). Second, during a 21-day prospective review (19 August 2019 to 9 September 2019), aLRTD admissions were identified, categorised by diagnosis and subsequently annualised. Hospital catchment denominators were calculated using linked general practice and hospitalisation data, with each practice\u2019s denominator contribution calculated based on practice population and per cent of the practices\u2019 hospitalisations admitted to the study hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Prospective review: 1322 adults screened; 410 identified with aLRTD. Retrospective review: 7727 adult admissions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The incidence of aLRTD and its subsets in the adult population of Southmead Hospital, Bristol UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Based on ICD-10 code analysis, annual incidences per 100 000 population were: aLRTD, 1901; pneumonia, 591; LRTI, 739; heart failure, 402. aLRTD incidence was highest among those \u226565 years: 65\u201374 (3684 per 100 000 adults), 75\u201384 (6962 per 100 000 adults) and \u226585 (11 430 per 100 000 adults). During the prospective review, 410\/1322 (31%) hospitalised adults had aLRTD signs\/symptoms and annualised incidences closely replicated retrospective analysis results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The aLRTD disease burden was high, increasing sharply with age. The aLRTD incidence is probably higher than estimated previously due to criteria specifying respiratory-specific symptoms or radiological change, usage of only the first diagnosis code and mismatch between case count sources and population denominators. This may have significant consequences for healthcare planning, including usage of current and future vaccinations against respiratory infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-057464","type":"journal-article","created":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T13:05:56Z","timestamp":1655298356000},"page":"e057464","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Incidence of acute lower respiratory tract disease hospitalisations, including pneumonia, among adults in Bristol, UK, 2019, estimated using both a prospective and retrospective methodology"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3923-1773","authenticated-orcid":false,"given":"Catherine","family":"Hyams","sequence":"first","affiliation":[{"name":"Academic Respiratory Unit, University of Bristol, Bristol, UK"},{"name":"Bristol Vaccine Centre, University of Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1287-5416","authenticated-orcid":false,"given":"Elizabeth","family":"Begier","sequence":"additional","affiliation":[{"name":"Global Medical and Scientific Affairs, Pfizer Inc, New York City, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Garcia Gonzalez","sequence":"additional","affiliation":[{"name":"Population Health Sciences, University of Bristol, Bristol, UK"},{"name":"Academic Respiratory Unit, Southmead Hospital, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo","family":"Southern","sequence":"additional","affiliation":[{"name":"Vaccines Medical Affairs, Pfizer Ltd, Tadworth, Surrey, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Campling","sequence":"additional","affiliation":[{"name":"Vaccines Medical Affairs, Pfizer Ltd, Tadworth, Surrey, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Gray","sequence":"additional","affiliation":[{"name":"Global Medical and Scientific Affairs, Pfizer Inc, New York City, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Oliver","sequence":"additional","affiliation":[{"name":"Bristol Vaccine Centre, University of Bristol, Bristol, UK"},{"name":"Schools of Cellular and Molecular Medicine and Population Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6216-7194","authenticated-orcid":false,"given":"Bradford D","family":"Gessner","sequence":"additional","affiliation":[{"name":"Vaccines Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Finn","sequence":"additional","affiliation":[{"name":"Bristol Vaccine Centre, University of Bristol, Bristol, UK"},{"name":"Population Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,6,15]]},"reference":[{"key":"2025121605333232000_12.6.e057464.1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00105513"},{"key":"2025121605333232000_12.6.e057464.2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-0062"},{"key":"2025121605333232000_12.6.e057464.3","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.rmed.2018.02.007","article-title":"Burden of pneumococcal community-acquired pneumonia in adults across Europe: a literature review","volume":"137","author":"Torres","year":"2018","journal-title":"Respir Med"},{"key":"2025121605333232000_12.6.e057464.4","unstructured":"European Lung White Book . Pneumonia. Available: https:\/\/www.erswhitebook.org\/chapters\/acute-lower-respiratory-infections\/pneumonia\/#:~:text=pneumonia%20(VAP).-,Incidence,000%20cases%20are%20expected%20annually [Accessed 25 Apr 2021]."},{"key":"2025121605333232000_12.6.e057464.5","unstructured":"British Lung Foundation . Pneumonia statistics. Available: https:\/\/statistics.blf.org.uk\/pneumonia [Accessed 25 Apr 2021]."},{"key":"2025121605333232000_12.6.e057464.6","unstructured":"Lim W , Lawrence H . National audit report: adult community acquired pneumonia audit 2018-2019. National audit period: 1 December 2018 \u2013 31 January 2019. 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