Antiviral therapy and outcomes of influenza requiring hospitalization in Ontario, Canada
Antiviral therapy and outcomes of influenza requiring hospitalization in Ontario, Canada
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DOI：
10.1086/523584
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发表时间：
2007-12-15
影响因子：
11.8
通讯作者：
Low, Donald E.
中科院分区：
文献类型：
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作者：
McGeer, Allison;Green, Karen A.;Low, Donald E.
背景我们进行了一项前瞻性队列研究，以评估抗病毒治疗对加拿大安大略南部流感住院患者预后的影响。2005年1月1日至2006年5月31日期间，因实验室确诊流感而入住多伦多侵入性细菌性疾病网络医院的患者入组本研究。通过患者和医生访谈和病历审查收集人口统计学和医学数据。评估的主要结局是症状发作后15天内的死亡。541例合格患者中有512例的数据可用。共有185名儿童（< 15岁），无一人死亡，也无一人接受抗病毒药物治疗。327名成年人的中位年龄为77岁（范围：15-98岁），166名（51%）为男性，245名（75%）患有慢性基础疾病，216名（71%）已接种流感疫苗。在327例成人患者中，184例（59%）在症状发作后48小时内到急诊科就诊，52例（16%）需要入住重症监护室，27例（8.3%）在症状发作后15天内死亡。大多数患者（292例患者; 89%）接受了抗菌治疗; 106例（32%）接受了抗病毒药物处方。抗流感病毒药物治疗与死亡率显著降低相关（比值比，0.21; 95%置信区间，0.06-0.80; P = 0.03）。抗病毒治疗对存活者的住院时间没有明显影响。在这一高度接种疫苗的人群中，流感造成的疾病负担很大。抗病毒药物治疗与死亡率显著降低相关。
Background. We conducted a prospective cohort study to assess the impact of antiviral therapy on outcomes of patients hospitalized with influenza in southern Ontario, Canada.Methods. Patients admitted to Toronto Invasive Bacterial Diseases Network hospitals with laboratory-confirmed influenza from 1 January 2005 through 31 May 2006 were enrolled in the study. Demographic and medical data were collected by patient and physician interview and chart review. The main outcome evaluated was death within 15 days after symptom onset.Results. Data were available for 512 of 541 eligible patients. There were 185 children (< 15 years of age), none of whom died and none of whom were treated with antiviral drugs. The median age of the 327 adults was 77 years (range, 15-98 years), 166 (51%) were male, 245 (75%) had a chronic underlying illness, and 216 (71%) had been vaccinated against influenza. Of the 327 adult patients, 184 (59%) presented to the emergency department within 48 h after symptom onset, 52 (16%) required intensive care unit admission, and 27 (8.3%) died within 15 days after symptom onset. Most patients (292 patients; 89%) received antibacterial therapy; 106 (32%) were prescribed antiviral drugs. Treatment with antiviral drugs active against influenza was associated with a significant reduction in mortality (odds ratio, 0.21; 95% confidence interval, 0.06-0.80; P = .03). There was no apparent impact of antiviral therapy on length of stay in survivors.Conclusions. There is a significant burden of illness attributable to influenza in this highly vaccinated population. Treatment with antiviral drugs was associated with a significant reduction in mortality.