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Severe morbidity among hospitalised adults with acute influenza and other respiratory infections: 2014-2015 and 2015-2016

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  • Severe morbidity among hospitalised adults with acute influenza and other respiratory infections: 2014-2015 and 2015-2016

    Epidemiol Infect. 2018 Jun 8:1-9. doi: 10.1017/S0950268818001486. [Epub ahead of print]
    Severe morbidity among hospitalised adults with acute influenza and other respiratory infections: 2014-2015 and 2015-2016.

    Segaloff HE1, Petrie JG1, Malosh RE1, Cheng CK1, McSpadden EJ1, Ferdinands JM2, Lamerato L3, Lauring AS4, Monto AS1, Martin ET1.
    Author information

    Abstract

    Our objective was to identify predictors of severe acute respiratory infection in hospitalised patients and understand the impact of vaccination and neuraminidase inhibitor administration on severe influenza. We analysed 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 (LOS). Two hundred sixteen of 1119 participants had PCR-confirmed influenza. Frailty score, Charlson score and tertile of prior-year healthcare visits were associated with LOS. Charlson score >2 (OR 1.5 (1.0-2.3)) was associated with ICU admission. Highest tertile of prior-year visits (OR 0.3 (0.2-0.7)) was associated with decreased ICU admission. Increasing tertile of visits (OR 1.5 (1.2-1.8)) was associated with 30-day readmission. Frailty and prior-year healthcare visits were associated with 30-day readmission among influenza-positive participants. Neuraminidase inhibitors were associated with decreased LOS among vaccinated participants with influenza A (HR 1.6 (1.0-2.4)). Overall, frailty and lack of prior-year healthcare visits were predictors of disease severity. Neuraminidase inhibitors were associated with reduced severity among vaccine recipients.


    KEYWORDS:

    Influenza; respiratory infections; vaccines

    PMID: 29880077 DOI: 10.1017/S0950268818001486
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