Christopher A Czaja1,2, Lisa Miller2, Nisha Alden1, Heidi L Wald3, Charisse Nitura Cummings4, Melissa A Rolfes4, Evan J Anderson5, Nancy M Bennett6, Laurie M Billing7, Shua J Chai4,8, Seth Eckel9, Robert Mansmann10, Melissa McMahon11, Maya L Monroe12, Alison Muse13, Ilene Risk14, William Schaffner15, Ann R Thomas16, Kimberly Yousey-Hindes17, Shikha Garg4, Rachel K Herlihy1. 1. Colorado Department of Public Health and Environment, Denver. 2. Colorado School of Public Health, Aurora. 3. SCL Health, Broomfield, Colorado. 4. Centers for Disease Control and Prevention, Atlanta, Georgia. 5. Emory University School of Medicine, Georgia Emerging Infections Program, and Atlanta Veteran's Affairs Medical Center. 6. University of Rochester School of Medicine and Dentistry, New York. 7. Ohio Department of Health, Columbus. 8. California Emerging Infections Program, Oakland. 9. Michigan Department of Health and Human Services, Lansing. 10. New Mexico Emerging Infections Program, Albuquerque. 11. Minnesota Department of Health, St. Paul. 12. Maryland Department of Health, Baltimore. 13. New York State Department of Health, Albany. 14. Salt Lake County Health Department, Utah. 15. Vanderbilt University School of Medicine, Nashville, Tennessee. 16. Oregon Public Health Division, Portland. 17. Connecticut Emerging Infections Program, Yale School of Public Health, New Haven.
Abstract
BACKGROUND: Rates of influenza hospitalizations differ by age, but few data are available regarding differences in laboratory-confirmed rates among adults aged ≥65 years. METHODS: We evaluated age-related differences in influenza-associated hospitalization rates, clinical presentation, and outcomes among 19 760 older adults with laboratory-confirmed influenza at 14 FluSurv-NET sites during the 2011-2012 through 2014-2015 influenza seasons using 10-year age groups. RESULTS: There were large stepwise increases in the population rates of influenza hospitalization with each 10-year increase in age. Rates ranged from 101-417, 209-1264, and 562-2651 per 100 000 persons over 4 influenza seasons in patients aged 65-74 years, 75-84 years, and ≥85 years, respectively. Hospitalization rates among adults aged 75-84 years and ≥85 years were 1.4-3.0 and 2.2-6.4 times greater, respectively, than rates for adults aged 65-74 years. Among patients hospitalized with laboratory-confirmed influenza, there were age-related differences in demographics, medical histories, and symptoms and signs at presentation. Compared to hospitalized patients aged 65-74 years, patients aged ≥85 years had higher odds of pneumonia (aOR, 1.2; 95% CI, 1.0-1.3; P = .01) and in-hospital death or transfer to hospice (aOR, 2.1; 95% CI, 1.7-2.6; P < .01). CONCLUSIONS: Age-related differences in the incidence and severity of influenza hospitalizations among adults aged ≥65 years can inform prevention and treatment efforts, and data should be analyzed and reported using additional age strata. Published by Oxford University Press on behalf of Infectious Diseases Society of America 2019.
BACKGROUND: Rates of influenza hospitalizations differ by age, but few data are available regarding differences in laboratory-confirmed rates among adults aged ≥65 years. METHODS: We evaluated age-related differences in influenza-associated hospitalization rates, clinical presentation, and outcomes among 19 760 older adults with laboratory-confirmed influenza at 14 FluSurv-NET sites during the 2011-2012 through 2014-2015 influenza seasons using 10-year age groups. RESULTS: There were large stepwise increases in the population rates of influenza hospitalization with each 10-year increase in age. Rates ranged from 101-417, 209-1264, and 562-2651 per 100 000 persons over 4 influenza seasons in patients aged 65-74 years, 75-84 years, and ≥85 years, respectively. Hospitalization rates among adults aged 75-84 years and ≥85 years were 1.4-3.0 and 2.2-6.4 times greater, respectively, than rates for adults aged 65-74 years. Among patients hospitalized with laboratory-confirmed influenza, there were age-related differences in demographics, medical histories, and symptoms and signs at presentation. Compared to hospitalized patients aged 65-74 years, patients aged ≥85 years had higher odds of pneumonia (aOR, 1.2; 95% CI, 1.0-1.3; P = .01) and in-hospital death or transfer to hospice (aOR, 2.1; 95% CI, 1.7-2.6; P < .01). CONCLUSIONS: Age-related differences in the incidence and severity of influenza hospitalizations among adults aged ≥65 years can inform prevention and treatment efforts, and data should be analyzed and reported using additional age strata. Published by Oxford University Press on behalf of Infectious Diseases Society of America 2019.
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