Increasing Rates of Gastroenteritis Hospital Discharges in US Adults and the Contribution of Norovirus, 1996-2007
Increasing Rates of Gastroenteritis Hospital Discharges in US Adults and the Contribution of Norovirus, 1996-2007
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DOI：
10.1093/cid/ciq163
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发表时间：
2011-02-01
影响因子：
11.8
通讯作者：
Parashar, Umesh D.
中科院分区：
文献类型：
--
作者：
Lopman, Ben A.;Hall, Aron J.;Parashar, Umesh D.
背景。腹泻仍然是一个重要的发病原因，但直到20世纪90年代中期，美国成年人因腹泻住院的人数一直在下降。我们的目的是描述最近肠胃炎住院的趋势，并确定诺如病毒的贡献。我们分析了1996-2007年期间所有与肠胃炎相关的出院病例，这些数据来自全国代表性的住院病人数据集。按年龄计算年排放率。采用原因指定排放作为解释变量拟合时间序列回归模型；分析模型残差以估计诺如病毒和轮状病毒相关的排出量。然后，我们计算了诺如病毒相关出院的年度医院收费。从1996年到2007年，69%的肠胃炎出院原因不明，在所有成人和老年年龄组（>= 18岁）中，发病率增加了50%。我们估计，每年平均有71,000例与诺如病毒相关的住院治疗，每年花费4.93亿美元，在流行季节，每年住院治疗人数激增至近11万人。我们还估计每年有24000名5岁以下的人因轮状病毒住院。肠胃炎住院治疗正在增加，我们估计诺如病毒是10%的病因不明和7%的全因肠胃炎出院的原因。诺如病毒应被常规认为是肠胃炎住院的原因。
Background. Diarrhea remains an important cause of morbidity, but until the mid 1990s, hospital admissions for diarrhea in the US adult population were declining. We aimed to describe recent trends in gastroenteritis hospitalizations and to determine the contribution of norovirus.Methods. We analyzed all gastroenteritis-associated hospital discharges during 1996-2007 from a nationally representative data set of hospital inpatient stays. Annual rates of discharges by age were calculated. Time-series regression models were fitted using cause-specified discharges as explanatory variables; model residuals were analyzed to estimate norovirus- and rotavirus-associated discharges. We then calculated the annual hospital charges for norovirus-associated discharges.Results. Sixty-nine percent of all gastroenteritis discharges were cause-unspecified and rates increased by >= 50% in all adult and elderly age groups (>= 18 years of age) from 1996 through 2007. We estimate an annual mean of 71,000 norovirus-associated hospitalizations, costing $493 million per year, with surges to nearly 110,000 hospitalizations per year in epidemic seasons. We also estimate 24,000 rotavirus hospitalizations annually among individuals aged >= 5 years.Conclusions. Gastroenteritis hospitalizations are increasing, and we estimate that norovirus is the cause of 10% of cause-unspecified and 7% of all-cause gastroenteritis discharges. Norovirus should be routinely considered as a cause of gastroenteritis hospitalization.