Objectives: We conducted a retrospective analysis of computerized hospitali
zation and regional meteorological and geophysical data in a university hos
pital in southern Israel. The aim of the study was to determine and depict
the seasonal variation in hospitalization for community-acquired pneumonia
(CAP-H) and the factors affecting it, for all age groups combined and by ag
e group, over a 5-year period,
Methods: AU cases of CAP-II over the period from January 1, 1990 to Decembe
r 31, 1994 were studied by season of the year and age group. The rates of C
AP-ii For the four seasons were compared by t-tests. Mathematical models ba
sed on quasi-Fourier generalized linear models were developed and used to e
valuate potential variables and their relative contributions to CAP-II.
Results: A total of 4101 CAP-I-I were analysed in the study, Throughput the
study period the prevalence of CAP-II was significantly higher in the wint
er and spring than in the summer and fall for all age groups combined and w
ithin each age group (P<0.00001). When CAP-PI was compared between the wint
er and the spring, we found that in the 0-16 age group CAP-PI was higher in
the winter (P<0.00001), in the 17-64 age group it was higher in the spring
(P<0.002), and in the 65+ age group as well as for all age groups combined
there were no significant differences between these two seasons. The most
important factor explaining the variance in CAP-PI in the 0-16 age group we
re direct and indirect effects of minimum daily temperature (31%), in the 1
7-64 age group direct and indirect effects of the difference between minimu
m and maximum daily temperatures (19%), and in the 65+ age group it was geo
physical factors (13%).
Conclusions: There is a significant seasonal variation in CAP-H with higher
rates for all age groups in the winter and spring. The extent to which the
prevalence of CAP-II is dominant in the winter and spring seasons differs
among the age groups, as does the principal variable explaining these diffe
rences. The most important factor is the direct and indirect effects of met
eorological variables in the 0-16 and 17-64 age groups, and a geophysical o
ne among the more elderly patients, (C) 1999 The British Infection Society.