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Moving mountains in community-acquired pneumonia: stone by stone we progress
  1. Frances Susanna Grudzinska
  1. Birmingham Acute Care Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
  1. Correspondence to Dr Frances Susanna Grudzinska, Birmingham Acute Care Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK; F.GRUDZINSKA{at}

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Community-acquired pneumonia (CAP) is a leading cause of hospitalisation with high inpatient mortality. Mortality and morbidity due to CAP are greater than that caused by exacerbations of chronic obstructive pulmonary disease (COPD) or asthma. The British Thoracic Society (BTS) CAP audit has revealed sustained improvements in inpatient mortality. However, emergency readmission within 30 days has increased.1

In the past 10 years, rates of severe pneumonia have fallen, and markers of high-quality care have all improved1 resulting in improved inpatient survival, so why are readmission rates climbing?

In this issue of Thorax, Lawrence et al show that 15.7% of people who survive an index admission are readmitted within 30 days. The readmitted group are older, have higher rates of common comorbidities, had higher severity CAP and were more likely to be discharged to a nursing or residential home. People who were readmitted were less likely to have undergone any microbiological testing. People with a positive pneumococcal antigen test were less likely to be readmitted, although this was not true for any other microbiological investigation.2

Pneumonia was the most common reason for readmission (39.6%), 22.9% of this group had hospital-acquired pneumonia. The authors compared participants readmitted with pneumonia with those readmitted with …

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  • Contributors FSG is the sole author.

  • Funding This study was funded by Dunhill Medical Trust (RTF1906\86).

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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