{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:43:41Z","timestamp":1789469021007,"version":"build-2803163510"},"reference-count":41,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Universidad Polit\u00e9cnica Salesiana Sede Cuenca, Ecuador"},{"id":[{"id":"https:\/\/ror.org\/00f11af73","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Acute respiratory infections (ARIs) remain a leading cause of hospitalization and preventable in-hospital mortality. This study aimed to characterize ARI hospitalizations and mortality in Ecuador and to identify factors associated with mortality across age groups. Materials and Methods: A cross-sectional study was conducted using national hospital data for 2015\u20132023. Crude hospitalization and in-hospital mortality rates were estimated by year and province. Age-adjusted temporal trends were evaluated using Joinpoint regression to obtain annual percentage change (APC). Univariable and multivariable logistic regression analyses were used to assess factors associated with in-hospital mortality in the overall, pediatric and adult populations. Results: A total of 576,195 ARI hospitalizations were analyzed: 51.24% were pediatric and 48.76% adult admissions. Although children accounted for most hospitalizations, in-hospital mortality was substantially higher among adults (14.04%) than among children (0.53%) and increased progressively with age. Age-adjusted rates had a significant annual increase among adults from 2015 to 2021 (APC 30.08% for hospitalization and 55.10% for mortality) and declined significantly from 2021 to 2023 (APC: \u221253.09% and \u221272.90%, respectively), whereas pediatric trends showed no significant changes. Lower respiratory tract infections, including bacterial pneumonia, viral pneumonia, and COVID-19, showed the highest odds of in-hospital death. Bronchiolitis was associated with increased odds of death in both pediatric and adult populations, with markedly stronger associations among adults. Rural residence and ethnicity showed age-specific associations with mortality, potentially reflecting differences in access to hospital care. During 2020\u20132021, COVID-19 accounted for 70.71% of ARI hospitalizations and nearly 87.17% of in-hospital deaths, with ARI hospitalization rates remaining above pre-pandemic levels thereafter. Conclusions: ARIs impose a substantial and unequal burden on Ecuador\u2019s health system. Mortality patterns may reflect age-related vulnerability, disease severity, and structural barriers to care rather than hospitalization volume alone, supporting the need for age-differentiated and equity-oriented public health strategies.<\/jats:p>","DOI":"10.3390\/medicina62091752","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T08:17:42Z","timestamp":1789114662000},"page":"1752","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute Respiratory Infections Hospitalizations and In-Hospital Mortality in Ecuador: Differences in Patterns Between Pediatric and Adult Populations"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4525-7534","authenticated-orcid":false,"given":"German Josuet","family":"Lapo-Talledo","sequence":"first","affiliation":[{"name":"Medicine Career, Pontificia Universidad Cat\u00f3lica del Ecuador Sede Esmeraldas, Esmeraldas 080101, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3493-6519","authenticated-orcid":false,"given":"Andr\u00e9s","family":"Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Carrera de Psicolog\u00eda Cl\u00ednica, Grupo de Investigaci\u00f3n en Neurociencia Cl\u00ednica Aplicada (GINCA), Universidad Polit\u00e9cnica Salesiana, Cuencua 010102, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Jorge Andr\u00e9s","family":"Talledo-Delgado","sequence":"additional","affiliation":[{"name":"School of Medicine, Faculty of Health Sciences, Universidad T\u00e9cnica de Manab\u00ed, Portoviejo 130105, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9555-0392","authenticated-orcid":false,"given":"Karime Montes","family":"Escobar","sequence":"additional","affiliation":[{"name":"Departamento de Formaci\u00f3n y Desarrollo Cient\u00edfico en Ingenier\u00eda, Facultad de Ingenier\u00eda Ciencia y Tecnolog\u00eda, Universidad Bernardo O\u2019Higgins, Santiago 8370993, Chile"},{"name":"Laboratorio de Funcionamiento de Agroecosistemas y Cambio Clim\u00e1tico-FAGROCLIM, Departamento de Ciencias Agr\u00edcolas, Facultad de Ingenier\u00eda Agr\u00edcola, Universidad T\u00e9cnica de Manab\u00ed, Portoviejo 130105, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6513-9654","authenticated-orcid":false,"given":"Pedro","family":"Mu\u00f1oz-Arteaga","sequence":"additional","affiliation":[{"name":"Carrera de Psicolog\u00eda Cl\u00ednica, Grupo de Investigaci\u00f3n en Neurociencia Cl\u00ednica Aplicada (GINCA), Universidad Polit\u00e9cnica Salesiana, Cuencua 010102, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1428-5081","authenticated-orcid":false,"given":"Vanessa","family":"Quito-Calle","sequence":"additional","affiliation":[{"name":"Carrera de Psicolog\u00eda Cl\u00ednica, Grupo de Investigaci\u00f3n en Neurociencia Cl\u00ednica Aplicada (GINCA), Universidad Polit\u00e9cnica Salesiana, Cuencua 010102, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6021-2649","authenticated-orcid":false,"given":"Lorena","family":"Ca\u00f1izares-Jarr\u00edn","sequence":"additional","affiliation":[{"name":"Carrera de Psicolog\u00eda Cl\u00ednica, Grupo de Investigaci\u00f3n en Neurociencia Cl\u00ednica Aplicada (GINCA), Universidad Polit\u00e9cnica Salesiana, Cuencua 010102, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Margot","family":"Moreira Toscano","sequence":"additional","affiliation":[{"name":"Facultad de Posgrado, Universidad T\u00e9cnica de Manab\u00ed, Portoviejo 130105, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Niederman, M.S., and Torres, A. 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