Epidemiology and outcomes of serious influenza-related infections in the cancer population
Epidemiology and outcomes of serious influenza-related infections in the cancer population
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DOI：
10.1002/cncr.21203
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发表时间：
2005-08-01
期刊：
影响因子：
6.2
通讯作者：
Elting, LS
中科院分区：
文献类型：
--
作者：
Cooksley, CD;Avritscher, EBC;Elting, LS
背景虽然癌症患者通常对疫苗接种反应良好，但他们可能不会每年接种流感疫苗。目前的人群为基础的研究描述了癌症患者中潜在的可预防的严重流感相关感染的流行病学和结果。从全国住院患者样本中，作者创建了一个子样本，其中包括任何国际疾病分类第九次修订版，癌症诊断代码和流感，支气管肺炎或由不明生物体引起的肺炎的主要诊断代码。根据后两个诊断代码，作者估计了每年和分层流感季节的超额病例，然后从秋季和冬季出院病例中随机选择样本。子集分析包括加权样本均值、频率和方差值分析。作者使用成本-费用比率将费用转换为成本，并将其夸大为2003年的美元。住院率和死亡率的计算采用5年癌症患病率估计。估计每年平均出院的癌症患者有可能预防的严重流感相关感染人数为16，000人。平均住院时间和每次住院费用分别为6天和> 6300美元。大约9%的患者在医院死亡，31%的患者需要进一步的专业护理。在流行癌症人群中，年龄< 65岁的患者的住院率和死亡率分别为219/10万和17.4/10万，年龄≥ 65岁的患者分别为623/10万和59.4/10万。年龄< 65岁的患者平均住院费用增加1300美元。据估计，9%的癌症住院患者死于流感相关感染。对癌症患者及其接触者使用推荐的疫苗接种计划减少了这一高度易感人群的住院、治疗延迟和死亡。Cancer 2005; 104：618-28. (c)2005年美国癌症协会。
BACKGROUND. Although patients with cancer generally respond favorably to vaccination, they may not receive annual influenza vaccinations. The current population-based study described the epidemiology and outcomes of potentially preventable, serious influenza-related infections in patients with cancer.METHODS. From the Nationwide Inpatient Sample, the authors created a sub-sample that included discharges with any International Classification of Diseases, ninth revision, diagnosis code for cancer and principal diagnosis code for influenza, bronchopneumonia, or pneumonia caused by an unspecified organism. From the latter two diagnosis codes, the authors estimated excess cases during the influenza season for each year and stratum, then selected a random sample from fall and winter discharges. Subset analyses included weighted sample means, frequencies, and analysis of variance values. The authors converted charges to costs using cost-to-charge ratios and inflated these to 2003 U.S. dollars. Hospitalization and mortality rates were calculated using 5-year cancer prevalence estimates.RESULTS. The estimated mean annual hospital discharges of patients with cancer with potentially preventable, serious influenza-related infections numbered 16,000. The average length and cost per stay were 6 days and > $6300, respectively. Approximately 9% of patients died in the hospital and 31% needed further skilled care. The estimated age-specific rates for hospitalization and death per 100,000 in the prevalent cancer population were 219 and 17.4, respectively, for patients age < 65 years and 623 and 59.4, respectively, for those age >= 65 years. Hospitalization costs averaged $1300 more for patients age < 65 years.CONCLUSIONS. Death from influenza-related infections occurred in an estimated 9% of patients with cancer hospitalized for such. Using recommended vaccination schedules for patients with cancer and their contacts reduced hospitalizations, treatment delays, and deaths in this highly susceptible population. Cancer 2005; 104:618-28. (c) 2005 American Cancer Society.