Enrique Gutiérrez-González1, José M Cantero-Escribano2, Lidia Redondo-Bravo2, Isabel San Juan-Sanz2, Ana Robustillo-Rodela2, Emilio Cendejas-Bueno3. 1. Unidad Docente de Medicina Preventiva y Salud Pública, Escuela Nacional de Sanidad-Instituto de Salud Carlos III, Madrid, Spain. Electronic address: e.gutierrez@isciii.es. 2. Servicio de Medicina Preventiva Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain. 3. Servicio de Microbiología, Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain.
Abstract
BACKGROUND: Identifying risk factors for complications or death associated with influenza remains crucial to target preventive interventions. Scores like the Charlson comorbidity index (CCI) may be of help. The aims of this study were to assess the effect of vaccination and comorbidities on severe influenza disease and influenza-related death among hospitalized patients during the season 2016/17; and to evaluate the validity of the CCI to predict death among these patients. METHODS: Data from adult patients (≥18 years old) with influenza infection admitted to La Paz University Hospital (LPUH) were recorded during the 2016/17 epidemic. The effect of influenza vaccine to prevent severe influenza or death was evaluated using multivariate logistic regression models. The area under the curve of the CCI and the age-adjusted CCI were compared to assess the predictive effect on mortality. RESULTS: A total of 342 adult patients with influenza infection were admitted, of which 83 developed severe influenza and 25 died during hospitalization. There were no differences between patients who survived and those who died concerning the CCI, but the age-adjusted CCI was higher in fatal cases (p-value=0.005). Influenza vaccine had no statistically significant effect on the risk of mortality (p-value=0.162) while age (OR: 1.12, p-value<0.001) and dementia (OR: 3.05, p-value=0.016) proved to be independent predictors for mortality. The seasonal vaccine was found to be protective for severe infection (OR: 0.54, p-value=0.019). The age-adjusted CCI was a better predictor of mortality than the crude CCI. CONCLUSIONS: Age and dementia are significant independent risk factors for mortality associated with influenza among hospitalized patients. The age-adjusted CCI seems to be a better predictor of mortality than the crude CCI. Influenza vaccine has shown to be effective in preventing severe influenza in the season 2016/17 among hospitalized patients and should be promoted in population at risk.
BACKGROUND: Identifying risk factors for complications or death associated with influenza remains crucial to target preventive interventions. Scores like the Charlson comorbidity index (CCI) may be of help. The aims of this study were to assess the effect of vaccination and comorbidities on severe influenza disease and influenza-related death among hospitalized patients during the season 2016/17; and to evaluate the validity of the CCI to predict death among these patients. METHODS: Data from adult patients (≥18 years old) with influenza infection admitted to La Paz University Hospital (LPUH) were recorded during the 2016/17 epidemic. The effect of influenza vaccine to prevent severe influenza or death was evaluated using multivariate logistic regression models. The area under the curve of the CCI and the age-adjusted CCI were compared to assess the predictive effect on mortality. RESULTS: A total of 342 adult patients with influenza infection were admitted, of which 83 developed severe influenza and 25 died during hospitalization. There were no differences between patients who survived and those who died concerning the CCI, but the age-adjusted CCI was higher in fatal cases (p-value=0.005). Influenza vaccine had no statistically significant effect on the risk of mortality (p-value=0.162) while age (OR: 1.12, p-value<0.001) and dementia (OR: 3.05, p-value=0.016) proved to be independent predictors for mortality. The seasonal vaccine was found to be protective for severe infection (OR: 0.54, p-value=0.019). The age-adjusted CCI was a better predictor of mortality than the crude CCI. CONCLUSIONS: Age and dementia are significant independent risk factors for mortality associated with influenza among hospitalized patients. The age-adjusted CCI seems to be a better predictor of mortality than the crude CCI. Influenza vaccine has shown to be effective in preventing severe influenza in the season 2016/17 among hospitalized patients and should be promoted in population at risk.
Authors: Florian Huemer; Gabriel Rinnerthaler; Benedikt Jörg; Patrick Morre; Birgit Stegbuchner; Elisabeth Proksch; Stefanie Fleimisch; Hannes Oberkofler; Iris Kremser; Richard Greil; Alexander Egle Journal: Geroscience Date: 2021-04-10 Impact factor: 7.713
Authors: Stefan Kluge; Julian Schulze Zur Wiesch; Thomas Theo Brehm; Marc van der Meirschen; Annette Hennigs; Kevin Roedl; Dominik Jarczak; Dominic Wichmann; Daniel Frings; Axel Nierhaus; Tim Oqueka; Walter Fiedler; Maximilian Christopeit; Christian Kraef; Alexander Schultze; Marc Lütgehetmann; Marylyn M Addo; Stefan Schmiedel Journal: Sci Rep Date: 2021-03-11 Impact factor: 4.379
Authors: Gavin H Harris; Kimberly J Rak; Jeremy M Kahn; Derek C Angus; Olivia R Mancing; Julia Driessen; David J Wallace Journal: JAMA Netw Open Date: 2021-03-01
Authors: Thomas Theo Brehm; Andreas Heyer; Kevin Roedl; Dominik Jarczak; Axel Nierhaus; Michael F Nentwich; Marc van der Meirschen; Alexander Schultze; Martin Christner; Walter Fiedler; Nicolaus Kröger; Tobias B Huber; Hans Klose; Martina Sterneck; Sabine Jordan; Benno Kreuels; Stefan Schmiedel; Marylyn M Addo; Samuel Huber; Ansgar W Lohse; Stefan Kluge; Julian Schulze Zur Wiesch Journal: J Clin Med Date: 2021-05-24 Impact factor: 4.241