Increasing Rate of Pneumonia Hospitalizations in the Bronx: A Sentinel Indicator for Human Immunodeficiency Virus

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Abstract
Drucker E (Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY 10467, USA) Webber M P, McMaster P and Vermund S H. Increasing rate of pneumonia hospitalizations in the Bronx: A sentinel indicator for human immunodeficiency virus. International Journal of Epidemiology 1989, 18: 926–933. To describe secular trends in pneumonia hospitalizations in the Bronx, New York City from 1982–1986, we analysed all cases with a discharge diagnosis of pneumonia, excluding Pneumocystis carinii pneumonia (PCP), for Bronx residents by age, sex, neighbourhood, and length of stay (N = 21 822). Hospital deaths from PCP and immune disorders were analysed separately as a non-recurrent indicator of human immunodeficiency virus (HIV) related disease prevalence by age, sex and geographical areas. From 1982 to 1986, pneumonia hospitalizations increased 132% among males and 100% among females aged 25–54, an age group accounting for 90% of adult AIDS cases in the Bronx, as compared to a 21% rise among males and 38% among females in all other age groups (p2 = 0.92). The observed increase in pneumonia hospitalizations, believed to be related to underlying prevalence patterns of HIV in this population, accounts for a significant and previously unrecognized burden on the local health care system. From 1983–1986, these ‘excess’ pneumonias in the Bronx accounted for 14 707 days of hospitalization—equal to 42% of the total days attributed to all hospital admissions for AIDS per se.