Yogesh Sharma1, Chris Horwood2, Paul Hakendorf2, Campbell Thompson3. 1. College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia; Department of General Medicine, Division of Medicine, Cardiac & Critical Care, Flinders Medical Centre, Adelaide, South Australia, Australia. Electronic address: Yogesh.Sharma@sa.gov.au. 2. Department of Clinical Epidemiology, Flinders Medical Centre, Adelaide, South Australia, Australia. 3. Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia.
Abstract
BACKGROUND: Worldwide, seasonal influenza causes significant mortality and poses a significant economic burden. Oseltamivir is an effective treatment, but benefits beyond immediate hospitalization are unknown. METHODS: This retrospective multicenter study included adult hospitalized influenza patients from two major teaching hospitals in Australia. Patients who received Oseltamivir <48 h of admission (prompt-treatment group) were compared with those who either did not receive treatment or if treatment was delayed by >48 h (delayed/no-treatment group). Propensity-score matching was used to balance confounders between two groups. Primary outcomes included 30-day readmissions, 30-day mortality, composite-outcome (30-day mortality and readmissions), in-hospital mortality, and hospital length of stay (LOS). RESULTS: Between January 2016-March 2020, 1828 adult patients mean (SD) age 66.4 (20.1), 52.9% females, were hospitalized with influenza. Four hundred and forty-eight (24.5%) received prompt-treatment with Oseltamivir, while 1380 (75.5%) patients were in the delayed/no-treatment group. The median (IQR) time from onset of symptoms to the administration of Oseltamivir was three (1-5) days. The propensity-score model included 245 matched patients in each group (standardized mean difference of <10%). Both 30-day readmissions and the composite-outcome were, respectively, 5.7% (P = 0.03) and 6.5% (P = 0.02) lower in patients who received prompt-treatment with Oseltamivir when compared to the delayed/no-treatment group. LOS showed a significant reduction, and in-hospital mortality showed a trend towards improvement among patients who received prompt-treatment when compared to the other group. CONCLUSIONS: Early administration of Oseltamivir was associated with a reduction in 30-days readmissions and composite-outcome of 30-day readmissions and mortality in adult hospitalized influenza patients when compared to delayed/no-treatment.
BACKGROUND: Worldwide, seasonal influenza causes significant mortality and poses a significant economic burden. Oseltamivir is an effective treatment, but benefits beyond immediate hospitalization are unknown. METHODS: This retrospective multicenter study included adult hospitalized influenza patients from two major teaching hospitals in Australia. Patients who received Oseltamivir <48 h of admission (prompt-treatment group) were compared with those who either did not receive treatment or if treatment was delayed by >48 h (delayed/no-treatment group). Propensity-score matching was used to balance confounders between two groups. Primary outcomes included 30-day readmissions, 30-day mortality, composite-outcome (30-day mortality and readmissions), in-hospital mortality, and hospital length of stay (LOS). RESULTS: Between January 2016-March 2020, 1828 adult patients mean (SD) age 66.4 (20.1), 52.9% females, were hospitalized with influenza. Four hundred and forty-eight (24.5%) received prompt-treatment with Oseltamivir, while 1380 (75.5%) patients were in the delayed/no-treatment group. The median (IQR) time from onset of symptoms to the administration of Oseltamivir was three (1-5) days. The propensity-score model included 245 matched patients in each group (standardized mean difference of <10%). Both 30-day readmissions and the composite-outcome were, respectively, 5.7% (P = 0.03) and 6.5% (P = 0.02) lower in patients who received prompt-treatment with Oseltamivir when compared to the delayed/no-treatment group. LOS showed a significant reduction, and in-hospital mortality showed a trend towards improvement among patients who received prompt-treatment when compared to the other group. CONCLUSIONS: Early administration of Oseltamivir was associated with a reduction in 30-days readmissions and composite-outcome of 30-day readmissions and mortality in adult hospitalized influenza patients when compared to delayed/no-treatment.