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Respiratory and Nonrespiratory Diagnoses Associated With Influenza in Hospitalized Adults.

ABSTRACT: Importance:Seasonal influenza virus infection is a major cause of morbidity and mortality and may be associated with respiratory and nonrespiratory diagnoses. Objective:To examine the respiratory and nonrespiratory diagnoses reported for adults hospitalized with laboratory-confirmed influenza between 2010 and 2018 in the United States. Design, Setting, and Participants:This cross-sectional study used data from the US Influenza Hospitalization Surveillance Network (FluSurv-NET) from October 1 through April 30 of the 2010-2011 through 2017-2018 influenza seasons. FluSurv-NET is a population-based, multicenter surveillance network with a catchment area that represents approximately 9% of the US population. Patients are identified by practitioner-ordered influenza testing. Adults (aged ?18 years) hospitalized with laboratory-confirmed influenza were included in the study. Exposures:FluSurv-NET defines laboratory-confirmed influenza as a positive influenza test result by rapid antigen assay, reverse transcription-polymerase chain reaction, direct or indirect fluorescent staining, or viral culture. Main Outcomes and Measures:Acute respiratory or nonrespiratory diagnoses were defined using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) discharge diagnosis codes. The analysis included calculation of the frequency of acute respiratory and nonrespiratory diagnoses with a descriptive analysis of patient demographic characteristics, underlying medical conditions, and in-hospital outcomes by respiratory and nonrespiratory diagnoses. Results:Of 89 999 adult patients hospitalized with laboratory-confirmed influenza, 76 649 (median age, 69 years; interquartile range, 55-82 years; 55% female) had full medical record abstraction and at least 1 ICD code for an acute diagnosis. In this study, 94.9% of patients had a respiratory diagnosis and 46.5% had a nonrespiratory diagnosis, including 5.1% with only nonrespiratory diagnoses. Pneumonia (36.3%), sepsis (23.3%), and acute kidney injury (20.2%) were the most common acute diagnoses. Fewer patients with only nonrespiratory diagnoses received antiviral therapy for influenza compared with those with respiratory diagnoses (81.4% vs 88.9%; P?

SUBMITTER: Chow EJ

PROVIDER: S-EPMC7084169 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Respiratory and Nonrespiratory Diagnoses Associated With Influenza in Hospitalized Adults.

Chow Eric J EJ Rolfes Melissa A MA O'Halloran Alissa A Alden Nisha B NB Anderson Evan J EJ Bennett Nancy M NM Billing Laurie L Dufort Elizabeth E Kirley Pam D PD George Andrea A Irizarry Lourdes L Kim Sue S Lynfield Ruth R Ryan Patricia P Schaffner William W Talbot H Keipp HK Thomas Ann A Yousey-Hindes Kimberly K Reed Carrie C Garg Shikha S

JAMA network open 20200302 3

<h4>Importance</h4>Seasonal influenza virus infection is a major cause of morbidity and mortality and may be associated with respiratory and nonrespiratory diagnoses.<h4>Objective</h4>To examine the respiratory and nonrespiratory diagnoses reported for adults hospitalized with laboratory-confirmed influenza between 2010 and 2018 in the United States.<h4>Design, setting, and participants</h4>This cross-sectional study used data from the US Influenza Hospitalization Surveillance Network (FluSurv-N ...[more]

PMID: 32196103

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Project description:BackgroundPreventing severe complications of influenza such as hospitalization is a public health priority; however, estimates of influenza vaccine effectiveness (VE) against influenza-associated acute lower respiratory tract infection (LRTI) hospitalizations are limited. We examined influenza VE against influenza-associated LRTIs in hospitalized adult patients.MethodsWe retrospectively analyzed data from a randomized trial of oseltamivir treatment in adults hospitalized with LRTI in Louisville, Kentucky, from 2010 to 2013. Patients were systematically tested for influenza at the time of enrollment. We estimated VE as 1 - the adjusted odds ratio (aOR) of antecedent vaccination in influenza-positives vs negatives × 100%. Vaccination status was obtained by patient self-report. Using logistic regression adjusting for age, sex, season, timing of illness, history of chronic lung disease, and activities of daily living, we estimated VE against hospitalized influenza-associated LRTIs and community-acquired pneumonia (CAP) with radiographic findings of infiltrate.ResultsOf 810 patients with LRTI (median age, 62 years), 184 (23%) were influenza-positive and 57% had radiographically confirmed CAP. Among influenza-positives and -negatives, respectively, 61% and 69% were vaccinated. Overall, 29% were hospitalized in the prior 90 days and >80% had comorbidities. Influenza-negatives were more likely to have a history of chronic obstructive pulmonary disease than influenza-positives (59% vs 48%; P = .01), but baseline medical conditions were otherwise similar. Overall, VE was 35% (95% CI, 4% to 56%) against influenza-associated LRTI and 51% (95% CI, 13% to 72%) against influenza-associated radiographically confirmed CAP.ConclusionsVaccination reduced the risk of hospitalization for influenza-associated LRTI and radiographically confirmed CAP. Clinicians should maintain high rates of influenza vaccination to prevent severe influenza-associated complications.

Dataset Information

Respiratory and Nonrespiratory Diagnoses Associated With Influenza in Hospitalized Adults.

Publications

Respiratory and Nonrespiratory Diagnoses Associated With Influenza in Hospitalized Adults.

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