The impact of influenza A(H1N1)pdm09 compared with seasonal influenza on intensive care admissions in New South Wales, Australia, 2007 to 2010: a time series analysis.
The impact of influenza A(H1N1)pdm09 compared with seasonal influenza on intensive care admissions in New South Wales, Australia, 2007 to 2010: a time series analysis.
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DOI：
10.1186/1471-2458-12-869
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发表时间：
2012-10-12
影响因子：
4.5
通讯作者：
Ward J
中科院分区：
文献类型：
--
作者：
Schaffer A;Muscatello D;Cretikos M;Gilmour R;Tobin S;Ward J
在澳大利亚，2009年甲型H1N1流感(H1N1)pdm09疫情导致重症监护室入院人数增加。每年流感对重症监护的贡献很难估计，因为许多没有典型流感综合征的流感患者可能无法进行实验室检测。我们使用以人口为基础的方法来估计和比较最近季节性流感和大流行性流感流行的影响。2007年至2010年，从澳大利亚新南威尔士州所有重症监护病房(ICU)入院的数据库中编制了描述不同人口群体健康结果的时间序列。Serfling方法是一种时间序列方法，用于在没有流感流行的情况下估计健康结果的季节性模式。通过从每个流行期的观测使用量中减去预期的季节性使用量来估计流感的影响。据估计，2007年每10万居民中与流感相关的呼吸系统ICU入院率(2.6/10万，95%可信区间2.0至3.1)是大流行年份2009年(0.76/10万，95%可信区间0.04至1.48)的三倍多。2009年呼吸系统ICU超额住院率以17岁至年龄段最高(2.9/10万，95%可信区间2.2~3.6)，2007年以65岁及以上人群最高(9.5/10万，95%可信区间6.2~12.8)。2009年，土著人的超标率为17/100,000(95%可信区间14至20)，孕妇为14/100,000(95%可信区间13至16)。虽然在2009年大流行性流感流行期间，流感被诊断得更频繁，重症监护的高峰使用率更高，但在2007年流感季节，呼吸系统疾病重症监护的总体超额入院率要高得多。因此，季节性流感对重症监护使用的影响以前可能被低估了。2009年，年轻人到中年人对重症监护病房的高使用率被老年人相对较低的使用率所抵消，土著人和孕妇在重症监护病房的比例大大超过。在大流行病规划中，更多地强调预防土著人民和孕妇的严重疾病应是优先事项。
In Australia, the 2009 epidemic of influenza A(H1N1)pdm09 resulted in increased admissions to intensive care. The annual contribution of influenza to use of intensive care is difficult to estimate, as many people with influenza present without a classic influenza syndrome and laboratory testing may not be performed. We used a population-based approach to estimate and compare the impact of recent epidemics of seasonal and pandemic influenza. For 2007 to 2010, time series describing health outcomes in various population groups were prepared from a database of all intensive care unit (ICU) admissions in the state of New South Wales, Australia. The Serfling approach, a time series method, was used to estimate seasonal patterns in health outcomes in the absence of influenza epidemics. The contribution of influenza was estimated by subtracting expected seasonal use from observed use during each epidemic period. The estimated excess rate of influenza-associated respiratory ICU admissions per 100,000 inhabitants was more than three times higher in 2007 (2.6/100,000, 95% CI 2.0 to 3.1) than the pandemic year, 2009 (0.76/100,000, 95% CI 0.04 to 1.48). In 2009, the highest excess respiratory ICU admission rate was in 17 to 64 year olds (2.9/100,000, 95% CI 2.2 to 3.6), while in 2007, the highest excess rate was in those aged 65 years or older (9.5/100,000, 95% CI 6.2 to 12.8). In 2009, the excess rate was 17/100,000 (95% CI 14 to 20) in Aboriginal people and 14/100,000 (95% CI 13 to 16) in pregnant women. While influenza was diagnosed more frequently and peak use of intensive care was higher during the epidemic of pandemic influenza in 2009, overall excess admissions to intensive care for respiratory illness was much greater during the influenza season in 2007. Thus, the impact of seasonal influenza on intensive care use may have previously been under-recognised. In 2009, high ICU use among young to middle aged adults was offset by relatively low use among older adults, and Aboriginal people and pregnant women were substantially over-represented in ICUs. Greater emphasis on prevention of serious illness in Aboriginal people and pregnant women should be a priority in pandemic planning.
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DOI：
10.1186/cc10331
发表时间：
2011-07-28
期刊：
Critical care (London, England)
影响因子：
--
作者：
Kuster SP;Katz KC;Blair J;Downey J;Drews SJ;Finkelstein S;Fowler R;Green K;Gubbay J;Hassan K;Lapinsky SE;Mazzulli T;McRitchie D;Pataki J;Plevneshi A;Powis J;Rose D;Sarabia A;Simone C;Simor A;McGeer A
通讯作者：
McGeer A
影响因子：
14.6
作者：
Campbell, Alexia;Rodin, Rachel;Pelletier, Louise
通讯作者：
Pelletier, Louise
影响因子：
11.4
作者：
Flint, Shaun M.;Davis, Joshua S.;Tong, Steven Y. C.
通讯作者：
Tong, Steven Y. C.
影响因子：
158.5
作者：
Louie, Janice K.;Acosta, Meileen;Honein, Margaret A.
通讯作者：
Honein, Margaret A.
影响因子：
6.4
作者：
Murata, Yoshihiko;Walsh, Edward E.;Falsey, Ann R.
通讯作者：
Falsey, Ann R.