Presentation (CTI)

OBJECTIVES: Pneumonia remains a leading cause of mortality in Portugal, which consistently ranks among the highest in the EU-27. This study characterises the national burden of pneumonia mortality and hospitalisation across age, sex, and the five Portuguese regions, with a focus on geographic asymmetries.
METHODS: National age-standardised death rates for Portugal and the EU-27 were obtained from Eurostat (2019-2023). National pneumonia deaths by age group and sex (2019-2023) and by health region (2019-2022) were obtained from statistics cause of death (National Institute of Statistics). In-hospital pneumonia mortality rate by region (2019-2025) was derived from hospital-level data from the National Health Service (Portal da Transparência), with institutions mapped to the five regions (Norte, Centro, Lisboa e Vale do Tejo, Alentejo, Algarve).
RESULTS: Portugal’s age-standardised pneumonia mortality rate exceeded the EU-27 average throughout 2019-2023 (excess 37.2-72.4%, mean 51.7%); in 2023, it reached 36.64 versus 24.97 deaths per 100,000 inhabitants, ranking 6th among 27 EU countries. Nationally, in 2023, 93.9% of 5,063 pneumonia deaths occurred in adults aged ≥65; deaths in women were more concentrated in those aged ≥85 than in men (70.5% vs 53.9%), despite more deaths among men overall (2,618 vs 2,445). Regionally, community deaths in 2019-2022 were concentrated in Centro (31.9%) and Norte (30.9%), with Algarve contributing the smallest proportion (5.7%). Additionally, Algarve had the highest mean in-hospital mortality rate (32.1% vs 18.7% Norte, 23.1% Centro, 25.5% LVT, 24.9% Alentejo), consistently across quarters, but was represented by one institution versus 15 in Norte and 9 in Centro.
CONCLUSIONS: Portugal's pneumonia mortality burden is concentrated in the oldest age groups and shows a marked geographic asymmetry. Further research should explore whether regional disparities are explained by differences in healthcare organisation, care delivery, access, or socioeconomic conditions.