{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:51:14Z","timestamp":1787028674911,"version":"build-2736575974"},"reference-count":49,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T00:00:00Z","timestamp":1595376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>To examine and compare in-hospital mortality (IHM) of community-acquired pneumonia (CAP) and non-ventilator hospital-acquired pneumonia (NV-HAP) among patients with or without bronchiectasis (BQ) using propensity score matching. A retrospective observational epidemiological study using the Spanish Hospital Discharge Records, 2016\u201317. We identified 257,455 admissions with CAP (3.97% with BQ) and 17,069 with NV-HAP (2.07% with BQ). Patients with CAP and BQ had less comorbidity, lower IHM, and a longer mean length of hospital stay (p &lt; 0.001) than non-BQ patients. They had a higher number of isolated microorganisms, including Pseudomonas aeruginosa. In patients with BQ and NV-HAP, no differences were observed with respect to comorbidity, in-hospital mortality (IHM), or mean length of stay. P. aeruginosa was more frequent (p = 0.028). IHM for CAP and NV-HAP with BQ was 7.89% and 20.06%, respectively. The factors associated with IHM in CAP with BQ were age, comorbidity, pressure ulcers, surgery, dialysis, and invasive ventilation, whereas in NV-HAP with BQ, the determinants were age, metastatic cancer, need for dialysis, and invasive ventilation. Patients with CAP and BQ have less comorbidity, lower IHM and a longer mean length of hospital stay than non-BQ patients. However, they had a higher number of isolated microorganisms, including Pseudomonas aeruginosa. In patients with BQ and NV-HAP, no differences were observed with respect to comorbidity, in-hospital mortality, or mean length of stay, but they had a greater frequency of infection by P. aeruginosa than non-BQ patients. Predictors of IHM for both types of pneumonia among BQ patients included dialysis and invasive ventilation.<\/jats:p>","DOI":"10.3390\/jcm9082339","type":"journal-article","created":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T11:26:01Z","timestamp":1595503561000},"page":"2339","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Hospitalizations for Community-Acquired and Non-Ventilator-Associated Hospital-Acquired Pneumonia in Spain: Influence of the Presence of Bronchiectasis. A Retrospective Database Study"],"prefix":"10.3390","volume":"9","author":[{"given":"Gema","family":"Sanchez-Mu\u00f1oz","sequence":"first","affiliation":[{"name":"Respiratory Department, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n (IiSGM),  28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5551-5181","authenticated-orcid":false,"given":"Ana","family":"L\u00f3pez-de-Andr\u00e9s","sequence":"additional","affiliation":[{"name":"Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorc\u00f3n, 28922 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valent\u00edn","family":"Hern\u00e1ndez-Barrera","sequence":"additional","affiliation":[{"name":"Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorc\u00f3n, 28922 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Pedraza-Serrano","sequence":"additional","affiliation":[{"name":"Respiratory Department, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n (IiSGM),  28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6119-4222","authenticated-orcid":false,"given":"Rodrigo","family":"Jimenez-Garcia","sequence":"additional","affiliation":[{"name":"Department of Public Health &amp; Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Lopez-Herranz","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, Physiotherapy and Podology, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Puente-Maestu","sequence":"additional","affiliation":[{"name":"Respiratory Department, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n (IiSGM),  28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4543-573X","authenticated-orcid":false,"given":"Javier de","family":"Miguel-Diez","sequence":"additional","affiliation":[{"name":"Respiratory Department, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n (IiSGM),  28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1157\/13128330","article-title":"Diagnosis and treatment of bronchiectasis. Spanish Society of Pneumology and Thoracic Surgery","volume":"44","author":"Vendrell","year":"2008","journal-title":"Arch. Bronconeumol"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.arbr.2017.07.013","article-title":"Spanish guidelines on the evaluation and diagnosis of bronchiectasis in adults","volume":"54","author":"Olveira","year":"2018","journal-title":"Arch. Bronconeumol"},{"key":"ref_3","first-page":"1","article-title":"British thoracic society guideline for bronchiectasis in adults","volume":"74","author":"Hill","year":"2019","journal-title":"Thorax"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Polverino, E., Goeminne, P.C., McDonnell, M.J., Aliberti, S., Marshall, S.E., Loebinger, M.R., Murris, M., Cant\u00f3n, R., Torres, A., and Dimakou, K. (2017). European respiratory society guidelines for the management of adult bronchiectasis. Eur. Respir. J., 50.","DOI":"10.1183\/13993003.00629-2017"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/01.cpm.0000171422.98696.ed","article-title":"Prevalence and economic burden of bronchiectasis","volume":"12","author":"Weycker","year":"2005","journal-title":"Clin. Pulm. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1183\/13993003.01033-2015","article-title":"Changes in the incidence, prevalence and mortality of bronchiectasis in the UK from 2004 to 2013: A population-based cohort study","volume":"47","author":"Quint","year":"2016","journal-title":"Eur. Respir. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1764","DOI":"10.1513\/AnnalsATS.201507-472OC","article-title":"Etiology of non-cystic fibrosis bronchiectasis in adults and its correlation to disease severity","volume":"12","author":"Lonni","year":"2015","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1111\/resp.12832","article-title":"Aetiology of bronchiectasis in adults: A systematic literature review","volume":"21","author":"Gao","year":"2016","journal-title":"Respirol"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.arbres.2016.12.003","article-title":"Etiology of bronchiectasis in a cohort of 2047 patients. An analysis of the Spanish Historical Bronchiectasis Registry","volume":"53","author":"Olveira","year":"2017","journal-title":"Arch. Bronconeumol"},{"key":"ref_10","first-page":"1","article-title":"Epidemiolog\u00eda actual y costes de las bronquiectasias","volume":"3","author":"Prados","year":"2016","journal-title":"Monogr. Arch. Bronconeumol"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"203","DOI":"10.21101\/cejph.b0014","article-title":"A bronchiectatic patient\u2019s risk of pneumnia and prognosis","volume":"17","author":"Saynajakangas","year":"2009","journal-title":"Cent. Eur. J. Public Health"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Sanchez-Mu\u00f1oz, G., L\u00f3pez de Andr\u00e9s, A., Jim\u00e9nez-Garc\u00eda, R., Carrasco-Garrido, P., Hern\u00e1ndez-Barrera, V., Pedraza-Serrano, F., and de Miguel-Diez, J. (2016). Time trends in hospital admissions for bronchiectasis: Analysis of the spanish national hospital discharge data (2004 to 2013). PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0162282"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.jinf.2018.04.006","article-title":"Pneumonic and non-pneumonic exacerbations in bronchiectasis: Clinical and microbiological differences","volume":"77","author":"Polverino","year":"2018","journal-title":"J. Infect."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.jinf.2015.03.009","article-title":"Microbiology and outcomes of community acquired pneumonia in non cystic-fibrosis bronchiectasis patients","volume":"71","author":"Polverino","year":"2015","journal-title":"J. Infect."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.jiac.2017.03.018","article-title":"Etiological analysis and epidemiological comparison among adult CAP and NHCAP patients in Okinawa, Japan","volume":"23","author":"Parrot","year":"2017","journal-title":"J. Infect. Chemother."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1513\/AnnalsATS.201407-305OC","article-title":"Risk factors associated with potentially antibiotic-resistant pathogens in communty-acquired pneumonia","volume":"12","author":"Prina","year":"2015","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1701190","DOI":"10.1183\/13993003.01190-2017","article-title":"Burden and risk factors for Pseudomonas aeruginosa community-acquired pneumonia: A multinational point prevalence study of hospitalised patients","volume":"52","author":"Restrepo","year":"2018","journal-title":"Eur. Respir. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/resp.12267","article-title":"Development and validation of a clinical risk score for predicting drug-resistant bacterial pneumonia in older Chinese patients","volume":"19","author":"Ma","year":"2014","journal-title":"Respirology"},{"key":"ref_19","unstructured":"Ministerio de Sanidad, Consumo y Bienestar Social (2020, March 07). Registro de Actividad de Atenci\u00f3n Especializada. RAE-CMBD, Available online: https:\/\/www.mscbs.gob.es\/estadEstudios\/estadisticas\/cmbdhome.htm."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J. Chronic. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1136\/thoraxjnl-2015-207688","article-title":"Increasing burden of community-acquired pneumonia leading to hospitalisation, 1998\u20132014","volume":"71","author":"Quan","year":"2016","journal-title":"Thorax"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Chou, C.L., Lee, W.R., Yeh, C.C., Shih, C.C., Chen, T.L., and Liao, C.C. (2015). Adverse outcomes after major surgery in patients with pressure ulcer: A nationwide population-based retrospective cohort study. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0127731"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1080\/10790268.2016.1180099","article-title":"Association between presence of pneumonia and pressure ulcer formation following traumatic spinal cord injury","volume":"40","author":"Krishnan","year":"2017","journal-title":"J. Spinal. Cord. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1080\/00273171.2011.568786","article-title":"An introduction to propensity score methods for reducing the effects of confounding in observational studies","volume":"46","author":"Austin","year":"2011","journal-title":"Multivar. Behav. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2265","DOI":"10.1002\/(SICI)1097-0258(19981015)17:19<2265::AID-SIM918>3.0.CO;2-B","article-title":"Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group","volume":"17","year":"1998","journal-title":"Stat. Med."},{"key":"ref_26","unstructured":"Szklo, M., and Nieto, F.J. (2014). Epidemiology: Beyond the Basics, Jones & Bartlett Learning."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1002\/clc.22972","article-title":"Impact of delirium on patients hospitalized for myocardial infarction: A propensity score analysis of the national inpatient sample","volume":"41","author":"Abdullah","year":"2018","journal-title":"Clin. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"15171","DOI":"10.1038\/s41598-018-33103-9","article-title":"Propensity-score-matched evaluation of under-recognition of acute kidney injury and short-term outcomes","volume":"8","author":"Wu","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Song, J.U., Kim, Y.H., Lee, M.Y., and Lee, J. (2019). The association of prior hospitalization with clinical outcomes among patients admitted with pneumonia: A propensity score matching study. BMC Infect. Dis., 19.","DOI":"10.1186\/s12879-019-3961-z"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Kuo, T.H., Yang, C.Y., Lee, C.H., Hsieh, C.C., Ko, W.C., and Lee, C.C. (2017). Propensity score matched analysis comparing the clinical outcome of Klebsiella pneumoniae and Escherichia coli causing community-onset monomicrobial bacteremia. Medicine (Baltimore), 96.","DOI":"10.1097\/MD.0000000000007075"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"541","DOI":"10.3389\/fpsyt.2019.00541","article-title":"Gender disparity in the risk of hypertension in subjects with major depressive disorder","volume":"10","author":"Kao","year":"2019","journal-title":"Front. Psychiatry"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1002\/sim.4200","article-title":"Comparing paired vs non-paired statistical methods of analyses when making inferences about absolute risk reductions in propensity-score matched samples","volume":"30","author":"Austin","year":"2011","journal-title":"Stat. Med."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Ringshausen, F.C., de Roux, A., Pletz, M.W., H\u00e4m\u00e4l\u00e4inen, N., Welte, T., and Rademacher, J. (2013). Bronchiectasis-associated hospitalizations in Germany, 2005-2011: A population-based study of disease urden and trends. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0071109"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1378\/chest.10-0099","article-title":"Trends and burden of bronchiectasis-associated hospitalizations in de United States, 1993-2006","volume":"138","author":"Seitz","year":"2010","journal-title":"Chest"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1378\/chest.125.5.1815","article-title":"Survival of patients with bronchiectasis after the first ICU stay for respiratory failure","volume":"125","author":"Dupont","year":"2004","journal-title":"Chest"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Scioscia, G., Amaro, R., Alcaraz-Serrano, V., Gabarr\u00fas, A., Oscanoa, P., and Fernandez, L. (2019). Clinical factors associated with a shorter or longer course of antibiotic treatment in patients with exacerbations of bronchiectasis: A prospective cohort study. J. Clin. Med., 8.","DOI":"10.3390\/jcm8111950"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Alzeer, A.H., Msod, M., Bsha, S.J., and Shaik, S.A. (2007). Survival of bronchiectatic patients with respiratory failure in ICU. BMC Pulm. Med., 7.","DOI":"10.1186\/1471-2466-7-17"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1093\/qjmed\/hcv206","article-title":"Critical care admission trends and outcomes in individuals with bronchiectasis in the UK","volume":"109","author":"Navaratnam","year":"2016","journal-title":"QJM"},{"key":"ref_39","first-page":"1565","article-title":"Factors associated with lung function decline in adult patients with stable non-cystic fibrosis bronchiectasis","volume":"132","author":"Soriano","year":"2017","journal-title":"Chest"},{"key":"ref_40","first-page":"1602","article-title":"A comprehensive analysis of the impact of Pseudomonas aeruginosa colonization on prognosis in adult bronchiectasis","volume":"12","author":"Finch","year":"2015","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1465-9921-13-21","article-title":"Risk factors for morbidity and death in non-cystic fibrosis bronchiectasis: A retrospective crosssectional analysis of CT diagnosed bronchiectatic patients","volume":"13","author":"Goeminn","year":"2012","journal-title":"Respir. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/j.rmed.2010.02.022","article-title":"Trends in bronchiectasis mortality in England and Wales","volume":"104","author":"Roberts","year":"2010","journal-title":"Respir. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1136\/thoraxjnl-2013-203739","article-title":"National BTS bronchiectasis audit 2012: Is the quality standard being adhered to in adult secondary care?","volume":"69","author":"Hill","year":"2014","journal-title":"Thorax"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1136\/thoraxjnl-2012-202893","article-title":"Bronchiectasis research & academic network. Research priorities in bronchiectasis","volume":"68","author":"Brown","year":"2013","journal-title":"Thorax"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1177\/1479972317709649","article-title":"Prevalence and incidence of noncystic fibrosis bronchiectasis among US adults in 2013","volume":"14","author":"Weycker","year":"2017","journal-title":"Chron. Respir. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Seifer, F.D., Hansen, G., and Weycker, D. (2019). Health-care utilization and expenditures among patients with comorbid bronchiectasis and chronic obstructive pulmonary disease in US clinical practice. Chron. Respir. Dis., 16.","DOI":"10.1177\/1479973119839961"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1378\/chest.14-2146","article-title":"Hospital discharges, readmissions, and ED visits for COPD or bronchiectasis among US adults: Findings from the nationwide inpatient sample 2001-2012 and nationwide emergency department sample 2006\u20132011","volume":"147","author":"Ford","year":"2015","journal-title":"Chest"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e020857","DOI":"10.1136\/bmjopen-2017-020857","article-title":"Validation of discharge diagnosis codes to identify serious infections among middle age and older adults","volume":"8","author":"Wiese","year":"2018","journal-title":"BMJ Open"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1002\/acr.21959","article-title":"Systematic review of validation studies of the use of administrative data to identify serious infections","volume":"65","author":"Barber","year":"2013","journal-title":"Arthritis. Care. Res. (Hoboken)"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/8\/2339\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:50:47Z","timestamp":1760176247000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/8\/2339"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,22]]},"references-count":49,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,8]]}},"alternative-id":["jcm9082339"],"URL":"https:\/\/doi.org\/10.3390\/jcm9082339","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,22]]}}}