Incidence of Outpatient Visits and Hospitalizations Related to Influenza in Infants and Young Children

O’Brien, Megan A.; Uyeki, Timothy M.; Shay, David K.; Thompson, W.; Kleinman, Ken; McAdam, Alexander J.; Yu, Xiaofei; Platt, Richard; Lieu, Tracy A.

doi:10.1542/peds.113.3.585

Cited by 244 publications

(155 citation statements)

References 19 publications

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“…Although estimated rates may be difficult to compare because of differences in study design, populations studied, seasons included, and geography, rate ratios between age groups should be similar. Here our findings are consistent with those from other studies12, 14, 15, 16, 17, 23: Young children bear the brunt of the outpatient influenza burden. Finally, although our study included >7 million persons, a larger population than other US studies, all data were from integrated health systems.…”

Section: Discussionsupporting

confidence: 93%

“…Both categories have been used in studies modeling the burden of influenza‐related illnesses 5, 6, 7, 16, 17. It is likely that use of the pneumonia category underestimates the outpatient burden of influenza, because influenza illnesses may be coded for with a variety of ICD‐9‐CM codes, including codes associated with bacterial infections, like bronchitis or sinusitis.…”

Section: Discussionmentioning

confidence: 99%

“…By contrast, influenza‐associated outpatient visits are plentiful, so rates of laboratory‐confirmed visits should be easier to document. However, relatively few studies have made population‐based estimates of influenza‐confirmed outpatient visit rates 12, 13, 14, 15, 16, 17. Most have focused on children, typically in a single site 12, 14, 15, 16, 17.…”

Section: Introductionmentioning

confidence: 99%

“…However, relatively few studies have made population‐based estimates of influenza‐confirmed outpatient visit rates 12, 13, 14, 15, 16, 17. Most have focused on children, typically in a single site 12, 14, 15, 16, 17. Often, few influenza‐confirmed cases are reported (range, 90‐372),12, 13, 15, 17 resulting in wide confidence intervals (CIs) around rate estimates.…”

Section: Introductionmentioning

confidence: 99%

“…Often, few influenza‐confirmed cases are reported (range, 90‐372),12, 13, 15, 17 resulting in wide confidence intervals (CIs) around rate estimates. While a key characteristic of influenza is season‐to‐season variability in intensity and severity, most studies have focused on a few seasons,12, 13, 17, 18 or reported summary estimates from multiple seasons 14, 15, 16. Finally, studies testing for influenza per protocol are not common,12, 13, 15, 17 as prospective studies are resource‐intensive.…”

Section: Introductionmentioning

confidence: 99%

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Estimated rates of influenza‐associated outpatient visits during 2001‐2010 in 6 US integrated healthcare delivery organizations

Zhou

Thompson

Belongia

et al. 2018

Influenza Resp Viruses

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BackgroundPopulation‐based estimates of influenza‐associated outpatient visits including both pandemic and interpandemic seasons are uncommon. Comparisons of such estimates with laboratory‐confirmed rates of outpatient influenza are rare.ObjectiveTo estimate influenza‐associated outpatient visits in 6 US integrated healthcare delivery organizations enrolling ~7.7 million persons.MethodsUsing negative binomial regression methods, we modeled rates of influenza‐associated visits with ICD‐9‐CM‐coded pneumonia or acute respiratory outpatient visits during 2001‐10. These estimated counts were added to visits coded specifically for influenza to derive estimated rates. We compared these rates with those observed in 2 contemporaneous studies recording RT‐PCR‐confirmed influenza outpatient visits.ResultsOutpatient rates estimated with pneumonia visits were 39 (95% confidence interval [CI], 30‐70) and 203 (95% CI, 180‐240) per 10 000 person‐years, respectively, for interpandemic and pandemic seasons. Corresponding rates estimated with respiratory visits were 185 (95% CI, 161‐255) and 542 (95% CI, 441‐823) per 10 000 person‐years. During the pandemic, children aged 2‐17 years had the largest increase in rates (when estimated with pneumonia visits, from 64 [95% CI, 50‐121] to 381 [95% CI, 366‐481]). Rates estimated with pneumonia visits were consistent with rates of RT‐PCR‐confirmed influenza visits during 4 of 5 seasons in 1 comparison study. In another, rates estimated with pneumonia visits during the pandemic for children and adults were consistent in timing, peak, and magnitude.ConclusionsEstimated rates of influenza‐associated outpatient visits were higher in children than adults during pre‐pandemic and pandemic seasons. Rates estimated with pneumonia visits plus influenza‐coded visits were similar to rates from studies using RT‐PCR‐confirmed influenza.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Estimated rates of influenza‐associated outpatient visits during 2001‐2010 in 6 US integrated healthcare delivery organizations

Zhou

Thompson

Belongia

et al. 2018

Influenza Resp Viruses

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Influenza Vaccination and Risk of Mortality Among Adults Hospitalized With Community-Acquired Pneumonia

Spaude

Abrutyn²,

Kirchner³

et al. 2007

Arch Intern Med

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Background: Influenza vaccination has been shown to reduce illness and all-cause mortality in vulnerable populations through the prevention of influenza infection. Attenuation of the severity of illness by vaccination has been reported for respiratory tract infections due to bacterial pathogens and would represent an important additional health benefit of influenza vaccination. We evaluated the impact of prior influenza vaccination on in-hospital mortality and other health outcomes among hospitalized adults with community-acquired pneumonia (CAP). Methods: Consecutive individuals hospitalized with CAP during "influenza season" (November to April, 1999-2003) at hospitals operated by Tenet HealthCare were identified using a database constructed to improve quality of patient care. Associations between vaccination status and all-cause in-hospital mortality were evaluated using logistic regression models.

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Influenza Vaccine Effectiveness Among Children 6 to 59 Months of Age During 2 Influenza Seasons

Szilâgyi

Fairbrother²,

Griffin³

et al. 2008

Arch Pediatr Adolesc Med

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Incidence of Outpatient Visits and Hospitalizations Related to Influenza in Infants and Young Children

Abstract: Influenza season is associated with a substantial increase in outpatient visits by healthy children. These estimates of outpatient visits for influenza will help quantify the potential health benefits and cost savings from influenza vaccination of healthy children aged 6 to 23 months.

Cited by 244 publications

References 19 publications

Estimated rates of influenza‐associated outpatient visits during 2001‐2010 in 6 US integrated healthcare delivery organizations

Estimated rates of influenza‐associated outpatient visits during 2001‐2010 in 6 US integrated healthcare delivery organizations

Influenza Vaccination and Risk of Mortality Among Adults Hospitalized With Community-Acquired Pneumonia

Influenza Vaccine Effectiveness Among Children 6 to 59 Months of Age During 2 Influenza Seasons

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