Effectiveness of Oseltamivir in reducing 30-day readmissions and mortality among patients with severe seasonal influenza in Australian hospitalized patients
Effectiveness of Oseltamivir in reducing 30-day readmissions and mortality among patients with severe seasonal influenza in Australian hospitalized patients
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DOI：
10.1016/j.ijid.2021.01.011
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发表时间：
2021-01-28
影响因子：
8.4
通讯作者：
Thompson, Campbell
中科院分区：
文献类型：
--
作者：
Sharma, Yogesh;Horwood, Chris;Thompson, Campbell
背景：在世界范围内，季节性流感造成严重的死亡率并造成严重的经济负担。奥司他韦是一种有效的治疗方法，但除了立即住院治疗之外的益处尚不清楚。方法：本回顾性多中心研究纳入了澳大利亚两家主要教学医院的成年住院流感患者。入院前48小时接受奥司他韦治疗的患者（及时治疗组）与未接受治疗或治疗延迟48小时（延迟/不治疗组）的患者进行比较。倾向得分匹配用于平衡两组之间的混杂因素。主要结局包括30天再入院率、30天死亡率、综合结局（30天死亡率和再入院率）、住院死亡率和住院时间（LOS）。结果：2016年1月至2020年3月期间，1828例平均（SD）年龄66.4(20.1)，其中52.9%为女性，因流感住院。448例（24.5%）患者接受了奥司他韦的及时治疗，而1380例（75.5%）患者属于延迟/未治疗组。从出现症状到给予奥司他韦的中位（IQR）时间为3（1-5）天。倾向-评分模型包括每组245例匹配患者（标准化平均差< 10%）。与延迟/不治疗组相比，及时接受奥司他韦治疗的患者30天再入院率和综合结果分别降低5.7% （P = 0.03）和6.5% （P = 0.02）。与另一组相比，接受及时治疗的患者的LOS显著降低，住院死亡率也有改善的趋势。结论：与延迟治疗/不治疗相比，早期给予奥司他韦可减少流感住院成人患者30天再入院率、30天再入院率和死亡率。(c) 2021提交人。由爱思唯尔有限公司代表国际传染病学会出版。这是一篇基于CC BY-NC-ND许可（http://creativecommons.org/licenses/by-nc-nd/4.0/）的开放获取文章。
Background: Worldwide, seasonal influenza causes significant mortality and poses a significant economic burden. Oseltamivir is an effective treatment, but benefits beyond immediate hospitalization are unknown.Methods: This retrospective multicenter study included adult hospitalized influenza patients from two major teaching hospitals in Australia. Patients who received Oseltamivir < 48 h of admission (prompt-treatment group) were compared with those who either did not receive treatment or if treatment was delayed by > 48 h (delayed/no-treatment group). Propensity-score matching was used to balance confounders between two groups. Primary outcomes included 30-day readmissions, 30-day mortality, composite-outcome (30-day mortality and readmissions), in-hospital mortality, and hospital length of stay (LOS).Results: Between January 2016-March 2020,1828 adult patients mean (SD) age 66.4 (20.1), 52.9% females, were hospitalized with influenza. Four hundred and forty-eight (24.5%) received prompt-treatment with Oseltamivir, while 1380 (75.5%) patients were in the delayed/no-treatment group. The median (IQR) time from onset of symptoms to the administration of Oseltamivir was three (1-5) days. The propensity-score model included 245 matched patients in each group (standardized mean difference of < 10%). Both 30 -day readmissions and the composite-outcome were, respectively, 5.7% (P = 0.03) and 6.5% (P = 0.02) lower in patients who received prompt-treatment with Oseltamivir when compared to the delayed/no-treatment group. LOS showed a significant reduction, and in-hospital mortality showed a trend towards improvement among patients who received prompt-treatment when compared to the other group.Conclusions: Early administration of Oseltamivir was associated with a reduction in 30-days readmissions and composite-outcome of 30-day readmissions and mortality in adult hospitalized influenza patients when compared to delayed/no-treatment.(c) 2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).