Age-Related Differences in Hospitalization Rates, Clinical Presentation, and Outcomes Among Older Adults Hospitalized With Influenza-US Influenza Hospitalization Surveillance Network (FluSurv-NET)
Age-Related Differences in Hospitalization Rates, Clinical Presentation, and Outcomes Among Older Adults Hospitalized With Influenza-US Influenza Hospitalization Surveillance Network (FluSurv-NET)
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DOI：
10.1093/ofid/ofz225
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发表时间：
2019-07-01
影响因子：
4.2
通讯作者：
Herlihy, Rachel K.
中科院分区：
文献类型：
--
作者：
Czaja, Christopher A.;Miller, Lisa;Herlihy, Rachel K.
背景。流感住院率因年龄而异，但关于 65 岁以上成年人实验室确诊率差异的数据很少。方法。我们使用 10 岁年龄组，在 2011-2012 年至 2014-2015 年流感季节期间，对 14 个 FluSurv-NET 站点的 19 760 名实验室确诊流感的老年人的流感相关住院率、临床表现和结果进行了与年龄相关的差异评估。结果。随着年龄每增加 10 岁，流感住院人口的比例大幅上升。在 4 个流感季节中，65-74 岁、75-84 岁和 85 岁以上患者的发病率分别为每 10 万人 101-417 例、209-1264 例和 562-2651 例。 75-84岁和≥85岁成年人的住院率分别是65-74岁成年人的1.4-3.0倍和2.2-6.4倍。在实验室确诊的流感住院患者中，人口统计学、病史以及就诊时的症状和体征存在与年龄相关的差异。与年龄 65-74 岁的住院患者相比，年龄 >= 85 岁的患者患肺炎的几率更高（aOR，1.2；95% CI，1.0-1.3；P = .01），院内死亡或转入临终关怀医院的几率更高（aOR，2.1；95% CI，1.7-2.6；P < .01）。结论。 65 岁以上成年人流感住院的发生率和严重程度与年龄相关的差异可以为预防和治疗工作提供信息，并且应使用其他年龄层来分析和报告数据。
Background. Rates of influenza hospitalizations differ by age, but few data are available regarding differences in laboratory-confirmed rates among adults aged >= 65 years.Methods. We evaluated age-related differences in influenza-associated hospitalization rates, clinical presentation, and outcomes among 19 760 older adults with laboratory-confirmed influenza at 14 FluSurv-NET sites during the 2011-2012 through 2014-2015 influenza seasons using 10-year age groups.Results. There were large stepwise increases in the population rates of influenza hospitalization with each 10-year increase in age. Rates ranged from 101-417, 209-1264, and 562-2651 per 100 000 persons over 4 influenza seasons in patients aged 65-74 years, 75-84 years, and >= 85 years, respectively. Hospitalization rates among adults aged 75-84 years and >= 85 years were 1.4-3.0 and 2.2-6.4 times greater, respectively, than rates for adults aged 65-74 years. Among patients hospitalized with laboratory-confirmed influenza, there were age-related differences in demographics, medical histories, and symptoms and signs at presentation. Compared to hospitalized patients aged 65-74 years, patients aged >= 85 years had higher odds of pneumonia (aOR, 1.2; 95% CI, 1.0-1.3; P = .01) and in-hospital death or transfer to hospice (aOR, 2.1; 95% CI, 1.7-2.6; P < .01).Conclusions. Age-related differences in the incidence and severity of influenza hospitalizations among adults aged >= 65 years can inform prevention and treatment efforts, and data should be analyzed and reported using additional age strata.