Epidemiology of Hospital Admissions with Influenza during the 2013/2014 Northern Hemisphere Influenza Season: Results from the Global Influenza Hospital Surveillance Network
Epidemiology of Hospital Admissions with Influenza during the 2013/2014 Northern Hemisphere Influenza Season: Results from the Global Influenza Hospital Surveillance Network
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DOI：
10.1371/journal.pone.0154970
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发表时间：
2016-05-19
期刊：
影响因子：
3.7
通讯作者：
Burtseva, Elena
中科院分区：
文献类型：
--
作者：
Puig-Barbera, Joan;Natividad-Sancho, Angels;Burtseva, Elena
全球流感医院监测网络成立于2012年，目的是获得流感样疾病住院的有效流行病学数据。在这里，我们描述了2013/2014年流感季节期间北方半球地区流感住院的流行病学，确定了严重结局和并发症的风险因素，并评估了不同流感病毒对高危人群临床相关结局的影响。和西班牙使用前瞻性的主动监视方法。符合常见病例定义的患者入组，并收集流行病学数据。通过多变量logistic回归分析确定了实验室确诊流感住院的危险因素，9507例连续住院患者中有5303例被纳入分析。其中，1086例为流感阳性（534例A（H3 N2），362例A（H1 N1），130例B/Yamagata谱系，3例B/维多利亚谱系，40例未分型A，18例未分型B）。流感住院的风险心血管疾病患者（校正比值比[95%置信区间]）升高（1.63 [1.33-2.02]），哮喘（2.25 [1.67-3.03]），免疫抑制（2.25 [1.23-4.11]）、肾脏疾病（2.11 [1.48-3.01]）、肝脏疾病（1.94 [1.18-3.19]）、自身免疫性疾病（2.97 [1.58-5.59]）和妊娠（3.84 [2.48-5.94]）。无合并症的患者占流感住院患者的60%。重症监护或住院死亡的需要在有或无流感的患者之间没有显著差异。流感疫苗接种与确诊流感的风险较低（调整后的比值比= 0.61 [0.48-0.77]）。妊娠和潜在的合并症增加了因流感样疾病住院的患者检测到流感病毒的风险。我们的研究结果支持流感疫苗接种作为降低流感相关住院风险的措施。
BackgroundThe Global Influenza Hospital Surveillance Network was established in 2012 to obtain valid epidemiologic data on hospital admissions with influenza-like illness. Here we describe the epidemiology of admissions with influenza within the Northern Hemisphere sites during the 2013/2014 influenza season, identify risk factors for severe outcomes and complications, and assess the impact of different influenza viruses on clinically relevant outcomes in at-risk populations.MethodsEligible consecutive admissions were screened for inclusion at 19 hospitals in Russia, Turkey, China, and Spain using a prospective, active surveillance approach. Patients that fulfilled a common case definition were enrolled and epidemiological data were collected. Risk factors for hospitalization with laboratory-confirmed influenza were identified by multivariable logistic regression.Findings5303 of 9507 consecutive admissions were included in the analysis. Of these, 1086 were influenza positive (534 A(H3N2), 362 A(H1N1), 130 B/Yamagata lineage, 3 B/Victoria lineage, 40 untyped A, and 18 untyped B). The risk of hospitalization with influenza (adjusted odds ratio [95% confidence interval]) was elevated for patients with cardiovascular disease (1.63 [1.33-2.02]), asthma (2.25 [1.67-3.03]), immunosuppression (2.25 [1.23-4.11]), renal disease (2.11 [1.48-3.01]), liver disease (1.94 [1.18-3.19], autoimmune disease (2.97 [1.58-5.59]), and pregnancy (3.84 [2.48-5.94]). Patients without comorbidities accounted for 60% of admissions with influenza. The need for intensive care or in-hospital death was not significantly different between patients with or without influenza. Influenza vaccination was associated with a lower risk of confirmed influenza (adjusted odds ratio = 0.61 [0.48-0.77]).ConclusionsInfluenza infection was detected among hospital admissions with and without known risk factors. Pregnancy and underlying comorbidity increased the risk of detecting influenza virus in patients hospitalized with influenza-like illness. Our results support influenza vaccination as a measure for reducing the risk of influenza-associated hospital admission.