Severe morbidity among hospitalised adults with acute influenza and other respiratory infections: 2014-2015 and 2015-2016.
Severe morbidity among hospitalised adults with acute influenza and other respiratory infections: 2014-2015 and 2015-2016.
复制标题
住院的成年人患有急性流感和其他呼吸道感染的严重发病率：2014-2015和2015-2016。
DOI：
10.1017/s0950268818001486
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发表时间：
2018-08
影响因子：
4.2
通讯作者：
Martin ET
中科院分区：
文献类型：
--
作者：
Segaloff HE;Petrie JG;Malosh RE;Cheng CK;McSpadden EJ;Ferdinands JM;Lamerato L;Lauring AS;Monto AS;Martin ET
我们的目的是确定严重急性呼吸道感染住院患者的预测因子，并了解疫苗接种和神经氨酸酶抑制剂给药对严重流感的影响。我们分析了一项研究的数据，该研究评估了2014-2015年和2015-2016年流感季节期间密歇根州两家医院的流感疫苗有效性。患有急性呼吸道感染住院的成人符合条件。通过患者访谈和病历回顾，我们评估了重症疾病的潜在危险因素，定义为ICU入院、30天再入院和住院时间。1072名参与者中有200人患有PCR确认的流感。虚弱评分、Charlson评分和前一年医疗保健就诊的三分位数与住院时间相关。Charlson评分>2（OR：1.6[1.0，2.4]）与ICU入院相关。前一年访视的最高三分位数（OR：0.4[0.2，0.7]）与ICU入院率下降相关。增加三分位数的访视（OR：1.4[1.2，1.8]）与30天再入院相关。虚弱和前一年的卫生保健访问与流感阳性参与者30天的再入院有关。神经氨酸酶抑制剂与接种疫苗的甲型流感受试者的住院时间缩短相关（HR：1.6 [1.0，2.4]）。总体而言，虚弱和缺乏前一年的医疗保健访问是疾病严重程度的预测因素。神经氨酸酶抑制剂与疫苗接种者的严重程度降低相关。
Our objective was to identify predictors of severe acute respiratory infection in hospitalized patients and understand the impact of vaccination and neuraminidase inhibitor administration on severe influenza. We analyzed data from a study evaluating influenza vaccine effectiveness in two Michigan hospitals during the 2014–2015 and 2015–2016 influenza seasons. Adults admitted to the hospital with an acute respiratory infection were eligible. Through patient interview and medical record review, we evaluated potential risk factors for severe disease, defined as ICU admission, 30-day readmission, and hospital length of stay. Two hundred of 1072 participants had PCR-confirmed influenza. Frailty score, Charlson score, and tertile of prior-year health care visits were associated with length of stay. Charlson score >2 (OR:1.6[1.0, 2.4]) was associated with ICU admission. Highest tertile of prior-year visits (OR:0.4[0.2, 0.7]) was associated with decreased ICU admission. Increasing tertile of visits (OR: 1.4[1.2, 1.8]) was associated with 30-day readmission. Frailty and prior-year health care visits were associated with 30-day readmission among influenza-positive participants. Neuraminidase inhibitors were associated with decreased length of stay among vaccinated participants with influenzaA (HR:1.6 [1.0, 2.4]). Overall, frailty and lack of prior-year health care visits were predictors of disease severity. Neuraminidase inhibitors were associated with reduced severity among vaccine recipients.