tetano
Editor, Senior Moderator
Clin Microbiol Infect. 2020 Apr 20. pii: S1198-743X(20)30218-4. doi: 10.1016/j.cmi.2020.04.013. [Epub ahead of print]
Comparison of influenza hospitalization outcomes among adults, older adults, and octogenarians: A US national population-based study.
Lee CC[SUP]1[/SUP], Liu Y[SUP]2[/SUP], Lu KT[SUP]3[/SUP], Wei C[SUP]4[/SUP], Su KY[SUP]5[/SUP], Hsu WT[SUP]6[/SUP], Chen SC[SUP]7[/SUP].
Author information
Abstract
OBJECTIVES:
This study sought to more fully elucidate the age-related trends in influenza mortality with a secondary goal of uncovering implications for treatment and prevention.
METHODS:
In this retrospective cohort analysis of data from the Nationwide Readmission Database, patients with influenza as a primary or secondary discharge diagnosis were separated into three age groups: 55,638 adults aged 20-64, 36,862 older adults aged 65-79, and 41,806 octogenarians aged ≧80. Propensity score (PS) weighting was performed to isolate age from other baseline differences. Crude and PS-weighted hazard ratios (HR) were calculated from the in-hospital all-cause 30-day mortality rate. Admission threshold bias was minimized by comparison of influenza with bacterial pneumonia mortality.
RESULTS:
Adults aged 20-64 experienced higher in-hospital 30-day mortality compared to older adults aged 65-79 (HR: 0.66; 95%CI: 0.55-0.79). Octogenarians had the highest mortality rate, but this was statistically insignificant compared to the adult cohort (HR: 1.09; 95%CI: 0.94-1.27). This trend was not explained by admission threshold bias: the 30-day mortality rate due to in-hospital bacterial pneumonia increased consistently with age (older adult HR: 1.45; 95%CI: 1.32-1.59; octogenarian HR: 1.99; 95%CI: 1.82-2.18).
CONCLUSIONS:
Adults aged 20-64 and octogenarians were more likely to suffer from all-cause 30-day mortality during influenza hospitalization compared to older adults aged 65-79. These data emphasize the importance of prevention and suggest the need for more tailored treatment interventions based on risk stratification that includes age.
Copyright ? 2020. Published by Elsevier Ltd.
KEYWORDS:
age; influenza; mortality; octogenarian
PMID:32325126DOI:10.1016/j.cmi.2020.04.013
Comparison of influenza hospitalization outcomes among adults, older adults, and octogenarians: A US national population-based study.
Lee CC[SUP]1[/SUP], Liu Y[SUP]2[/SUP], Lu KT[SUP]3[/SUP], Wei C[SUP]4[/SUP], Su KY[SUP]5[/SUP], Hsu WT[SUP]6[/SUP], Chen SC[SUP]7[/SUP].
Author information
Abstract
OBJECTIVES:
This study sought to more fully elucidate the age-related trends in influenza mortality with a secondary goal of uncovering implications for treatment and prevention.
METHODS:
In this retrospective cohort analysis of data from the Nationwide Readmission Database, patients with influenza as a primary or secondary discharge diagnosis were separated into three age groups: 55,638 adults aged 20-64, 36,862 older adults aged 65-79, and 41,806 octogenarians aged ≧80. Propensity score (PS) weighting was performed to isolate age from other baseline differences. Crude and PS-weighted hazard ratios (HR) were calculated from the in-hospital all-cause 30-day mortality rate. Admission threshold bias was minimized by comparison of influenza with bacterial pneumonia mortality.
RESULTS:
Adults aged 20-64 experienced higher in-hospital 30-day mortality compared to older adults aged 65-79 (HR: 0.66; 95%CI: 0.55-0.79). Octogenarians had the highest mortality rate, but this was statistically insignificant compared to the adult cohort (HR: 1.09; 95%CI: 0.94-1.27). This trend was not explained by admission threshold bias: the 30-day mortality rate due to in-hospital bacterial pneumonia increased consistently with age (older adult HR: 1.45; 95%CI: 1.32-1.59; octogenarian HR: 1.99; 95%CI: 1.82-2.18).
CONCLUSIONS:
Adults aged 20-64 and octogenarians were more likely to suffer from all-cause 30-day mortality during influenza hospitalization compared to older adults aged 65-79. These data emphasize the importance of prevention and suggest the need for more tailored treatment interventions based on risk stratification that includes age.
Copyright ? 2020. Published by Elsevier Ltd.
KEYWORDS:
age; influenza; mortality; octogenarian
PMID:32325126DOI:10.1016/j.cmi.2020.04.013