2592. The Incidence Rate Of Pneumococcal Pneumonia In Two European Aging Adults Population Using Real-World Data
Authors: López-lacort Mónica , Amini Marzyeh , Emborg Hanne-Dorthe , Nielsen Jens , Valentiner-Branth Palle , Winje Brita Askeland , Steens Anneke , McDonald Scott A , Johnson Kelly D , Savic Miloje , Díez-Domingo Javier , Orrico-Sánchez Alejandro 
Published: November 2023

Abstract

Background
Pneumococcal pneumonia (PP) is a major infectious cause of morbidity and mortality worldwide. It is occurring predominantly in the elderly and those with co-morbidities. To guide policymakers about prevention strategies it is essential to understand the disease occurrence in the population. In the context of the Vaccines and InfecTious Diseases in the Aging PopuLation (VITAL) project, this study aimed to assess PP incidence rates in aging adults (50+ years) in two European countries, Spain and Denmark, using real-world data.

Methods
We conducted a retrospective analysis within the electronic healthcare record (EHR) of the Valencia Health System Integrated Databases of Spain and Statens Serum Institute Database of Denmark. We identified hospitalized invasive PP (IPP) and non-invasive PP (NIPP) cases occurring from January 1, 2010 through December 31, 2018, using a combination of microbiological testing and clinical (ICD9/10 diagnoses for disease manifestations) data recorded within the EHR. Overall incidence per 100,000 person-years (PYs) was estimated and stratified by age group, sex, underlying condition, and calendar year.

Results
A study population of 2,283,344 and 2,782,303 aging adults were included from Valencia and Denmark, respectively. The overall incidence rate of IPP for all years collectively was higher in the Danish than in the Valencia population (18.3 vs. 9.8/100,000 PYs), while the incidence rate of NIPP in the Valencia population was substantially higher (48.2 vs. 7.2/100,000 PYs). The incidence of IPP increased along with age, ranging from 3.9/100,000 PYs in 50-55 years-old to 23.0 in ≥80 years-olds in Valencia, and 5.9/100,000 PYs in 50-55 years-old to 47.3 in ≥80 years-old in Denmark. The incidence rate of NIPP showed the same age-group trend. In both countries, the incidence rate of (N)IPP differed over the years and in both sex but was higher in patients with underlying conditions.

Conclusion
The incidence rates of (N)IPP fluctuated over the years and increased with age in both countries. However, substantial between-country variation was observed. The differences in incidence rates in two geographically distinct countries may be in large parts attributable to bias due to testing rates and coding practice, and for IPP also on pre-hospital antibiotic use.

Disclosures
Mónica López-lacort, n/a, GSK: Grant/Research Support|Merck: Grant/Research Support|Merck: Honoraria|Sanofi: Grant/Research Support Kelly, D Johnson, n/a, Merck: Stocks/Bonds Miloje Savic, PhD, GSK Biologicals: Stocks/Bonds Alejandro Orrico-Sánchez, GSK: Grant/Research Support|Merck: Advisor/Consultant|Merck: Board Member|Merck: Grant/Research Support|Merck: Honoraria|Pfizer: Grant/Research Support|Sanofi: Board Member|Sanofi: Grant/Research Support|Sanofi: Honoraria