tetano
Editor, Senior Moderator
Euro Surveill. 2019 Oct;24(44). doi: 10.2807/1560-7917.ES.2019.24.44.1900087. [h=1]Influenza-associated mortality in hospital care: a retrospective cohort study of risk factors and impact of oseltamivir in an English teaching hospital, 2016 to 2017.[/h]
Reacher M[SUP]1,[/SUP][SUP]2[/SUP], Warne B[SUP]3[/SUP], Reeve L[SUP]2[/SUP], Verlander NQ[SUP]4[/SUP], Jones NK[SUP]3[/SUP], Ranellou K[SUP]5,[/SUP][SUP]3[/SUP], Christou S[SUP]3[/SUP], Wright C[SUP]3[/SUP], Choudhry S[SUP]3[/SUP], Zambon M[SUP]6[/SUP], Sander C[SUP]3[/SUP], Zhang H[SUP]1[/SUP], Jalal H[SUP]1[/SUP].
[h=3]Author information[/h] 1 Public Health England and Cambridge Universities Hospitals NHS Foundation Trust Cambridge, Cambridge, United Kingdom. 2 Public Health England Field Service, Cambridge Institute of Public Health, Cambridge, United Kingdom. 3 Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. 4 Statistics Unit, Statistics, Modelling and Economics Department, National Infection Service - Data and Analytical Sciences, Public Health England, London, United Kingdom. 5 Division of Virology, Department of Pathology, University of Cambridge, United Kingdom. 6 National Infection Service, Public Health England, London, United Kingdom.
[h=3]Abstract[/h] BackgroundEvidence of an oseltamivir treatment effect on influenza A(H3N2) virus infections in hospitalised patients is incomplete.AimsThis cohort study aimed to evaluate risk factors for death among PCR-confirmed hospitalised cases of seasonal influenza A(H3N2) of all ages and the impact of oseltamivir.MethodsParticipants included all 332 PCR-confirmed influenza A(H3N2) cases diagnosed between 30 August 2016 and 17 March 2017 in an English university teaching Hospital. Oseltamivir treatment effect on odds of inpatient death was assessed by backward stepwise multivariable logistic regression analysis.ResultsThe odds of death were reduced by two thirds (odds ratio (OR): 0.32; 95% confidence interval (CI): 0.11-0.93), in inpatients treated with a standard course of oseltamivir 75 mg two times daily for 5 days - compared with those untreated with oseltamivir, after adjustment for age, sex, current excess alcohol intake, receipt of 2016/17 seasonal influenza vaccine, serum haemoglobin and hospital vs community attribution of acquisition of influenza.ConclusionsOseltamivir treatment given according to National Institutes of Clinical Excellence (NICE); United States Centres for Disease Control and Prevention (CDC); Infectious Diseases Society of America (IDSA) and World Health Organization (WHO) guidelines was shown to be effective in reducing the odds of mortality in inpatients with PCR-confirmed seasonal influenza A(H3N2) after adjustment in a busy routine English hospital setting. Our results highlight the importance of hospitals complying with relevant guidelines for prompt seasonal influenza PCR testing and ensuring standard oseltamivir treatment to all PCR-confirmed cases of seasonal influenza.
[h=4]KEYWORDS:[/h] Historic Cohort study; in-patient mortality; influenza; logistic regression; multivariable logistic regression; risk factors
PMID: 31690364 DOI: 10.2807/1560-7917.ES.2019.24.44.1900087
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Reacher M[SUP]1,[/SUP][SUP]2[/SUP], Warne B[SUP]3[/SUP], Reeve L[SUP]2[/SUP], Verlander NQ[SUP]4[/SUP], Jones NK[SUP]3[/SUP], Ranellou K[SUP]5,[/SUP][SUP]3[/SUP], Christou S[SUP]3[/SUP], Wright C[SUP]3[/SUP], Choudhry S[SUP]3[/SUP], Zambon M[SUP]6[/SUP], Sander C[SUP]3[/SUP], Zhang H[SUP]1[/SUP], Jalal H[SUP]1[/SUP].
[h=3]Author information[/h] 1 Public Health England and Cambridge Universities Hospitals NHS Foundation Trust Cambridge, Cambridge, United Kingdom. 2 Public Health England Field Service, Cambridge Institute of Public Health, Cambridge, United Kingdom. 3 Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. 4 Statistics Unit, Statistics, Modelling and Economics Department, National Infection Service - Data and Analytical Sciences, Public Health England, London, United Kingdom. 5 Division of Virology, Department of Pathology, University of Cambridge, United Kingdom. 6 National Infection Service, Public Health England, London, United Kingdom.
[h=3]Abstract[/h] BackgroundEvidence of an oseltamivir treatment effect on influenza A(H3N2) virus infections in hospitalised patients is incomplete.AimsThis cohort study aimed to evaluate risk factors for death among PCR-confirmed hospitalised cases of seasonal influenza A(H3N2) of all ages and the impact of oseltamivir.MethodsParticipants included all 332 PCR-confirmed influenza A(H3N2) cases diagnosed between 30 August 2016 and 17 March 2017 in an English university teaching Hospital. Oseltamivir treatment effect on odds of inpatient death was assessed by backward stepwise multivariable logistic regression analysis.ResultsThe odds of death were reduced by two thirds (odds ratio (OR): 0.32; 95% confidence interval (CI): 0.11-0.93), in inpatients treated with a standard course of oseltamivir 75 mg two times daily for 5 days - compared with those untreated with oseltamivir, after adjustment for age, sex, current excess alcohol intake, receipt of 2016/17 seasonal influenza vaccine, serum haemoglobin and hospital vs community attribution of acquisition of influenza.ConclusionsOseltamivir treatment given according to National Institutes of Clinical Excellence (NICE); United States Centres for Disease Control and Prevention (CDC); Infectious Diseases Society of America (IDSA) and World Health Organization (WHO) guidelines was shown to be effective in reducing the odds of mortality in inpatients with PCR-confirmed seasonal influenza A(H3N2) after adjustment in a busy routine English hospital setting. Our results highlight the importance of hospitals complying with relevant guidelines for prompt seasonal influenza PCR testing and ensuring standard oseltamivir treatment to all PCR-confirmed cases of seasonal influenza.
[h=4]KEYWORDS:[/h] Historic Cohort study; in-patient mortality; influenza; logistic regression; multivariable logistic regression; risk factors
PMID: 31690364 DOI: 10.2807/1560-7917.ES.2019.24.44.1900087
Free full text