Definition

These codes will capture both community- and hospital-acquired pneumonia. These codes are not intended to be mandatory, but are to be used as a starting point for the identification of pneumonia in routine EHR. Each study may differ in the sensitivity and specificity of the coding required.

Defining a community-acquired pneumonia occurrence in CPRD and HES, Millett et al. 2013 used the following algorithm:

1) Pneumonia records wtihin 28 days of each other were considered to be separate consultations for the same illness 2) First record of pneumonia was the index date 3) End of a pneumonia occurrence was defined as 28 days after the last pneumonia code within the illness episode 4) In HES, pneumonia coded as the primary diagnosis on the first day of a hospital admission

Defining a hospital-acquired pneumonia occurrence in HES and CPRD, Millett et al. 2013 used the following algorithm:

1) Pneumonia coded at any time beyond the first day of a hospital admission 2) Using CPRD in conjunction with HES, pneumonia coded in CPRD within 14 days of a hospital admission (for any cause) was deemed hospital-acquired 3) In CPRD, use of a hospital-acquired pneumonia code at any time during the pneumonia occurrence

Millett, E. R., Quint, J. K., Smeeth, L., Daniel, R. M., & Thomas, S. L. (2013). Incidence of community-acquired lower respiratory tract infections and pneumonia among older adults in the United Kingdom: a population-based study. PLoS One, 8(9), e75131. doi:10.1371/journal.pone.0075131

Defining a community-acquired pneumonia resulting in hospitalisation occurrence in HES, Hicks et al. 2016 used the following algorithm:

1) In HES, hospital admission following A&E visit, where pneumonia was coded as the primary diagnosis within two days of admission

Defining a hospital-acquired pneumonia occurrence in CPRD and HES, Hicks et al. 2016 used the following algorithm:

1) Pneumonia diagnosis in HES >2 days after hospital admission 2) Pneumonia diagnosed in CPRD within 7 days after hospital discharge

Hicks, B. M., Yin, H., Bladou, F., Ernst, P., & Azoulay, L. (2017). Androgen deprivation therapy for prostate cancer and the risk of hospitalisation for community-acquired pneumonia. Thorax, 72(7), 596-597. doi:10.1136/thoraxjnl-2016-209512

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