Predictors of Hospitalization and Admission to Intensive Care Units of Influenza Patients in Serbia through Four Influenza Seasons from 2010/2011 to 2013/2014

Dimitrijević, Dragana; Ilić, Dragan; Adrović, Slavica Rakić; Šuljagić, Vesna; Pelemiš, Mijomir; Stevanović, Goran; Milinković, M; Grujičić, Sandra Šipetić

doi:10.7883/yoken.jjid.2016.210

Cited by 9 publications

(7 citation statements)

References 14 publications

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“…On this point, the age of patients has been reported to positively correlate with a more severe outcome and death, either during 2009 influenza pandemic 28,29 or subsequent seasonal epidemics. 19,27,[30][31][32] In our setting, adults older than 14 years had a baseline higher risk of being admitted to an ICU than pediatric population, and the age-adjusted OR further increased among influenza-positive cases. In general, the median age of patients significantly grew up with disease severity and this was about 50 years and older among hospitalized patients.…”

Section: Discussionmentioning

confidence: 66%

Surveillance Data for Eight Consecutive Influenza Seasons in Sicily, Italy

Tramuto

Restivo

Costantino

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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Influenza A and B outbreaks occur each year with different activity and molecular patterns. To date, knowledge of seasonal epidemiology remains a prerequisite not only to put in place the most effective immunization strategy against influenza but also to identify population groups at higher risk of developing serious complications. A retrospective analysis of influenza surveillance data from 2010 to 2018 aimed to explore the epidemiology of influenza in Sicily, at the primary care and hospital level. Overall, 6,740 patients with acute respiratory infection were tested, of which 3,032 (45.0%) were positive for influenza. The relative proportion of type A and B viruses markedly varied across seasons. Type A similarly spreads among children and adults, whereas type B was more commonly identified among pediatric population aged 5-9 years. The median age of confirmed influenza cases differed by health-care setting, increasing according to disease severity (range: 8-54 years). Among influenza-confirmed cases, more than 80% of hospitalized patients had an underlying medical condition. Cardiovascular disease, lung disease, diabetes, and obesity were some of the most frequent. Overall, patients admitted to an intensive care unit were more likely to have multiple comorbidities and being infected with influenza infection strongly increased the risk of severe clinical outcomes. Understanding of the epidemiology of influenza and the molecular features of circulating viruses is of paramount importance to optimize prevention and control strategies. Knowledge of predictors for the occurrence of severe forms of the disease may help to address adequate preventive measures to high-risk population groups.

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Section: Discussionmentioning

confidence: 66%

Surveillance Data for Eight Consecutive Influenza Seasons in Sicily, Italy

Tramuto

Restivo

Costantino

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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“… 32 Despite the recognized need for subjects at increased risk of influenza complications to be vaccinated, coverage in children with asthma is low, with rates of ˜18%–20% in Spain, ˜15% in France and 2.5%–20% in Italy, compared with ˜50% in the United States. 32 Morbid obesity has been associated with increased influenza disease in some adult studies, 33 – 35 and may also be a risk factor for children, 36 although it may not be an independent factor for influenza complications requiring hospitalization or resulting in death. 4 , 37 Because this study was conducted in young children across North America, Europe and Asia, morbid obesity was defined according to the judgment of the investigators, rather than by uniform criteria based on body mass index.…”

Section: Discussionmentioning

confidence: 99%

Immunogenicity and Safety of an MF59-adjuvanted Quadrivalent Seasonal Influenza Vaccine in Young Children at High Risk of Influenza-associated Complications: A Phase III, Randomized, Observer-blind, Multicenter Clinical Trial

Esposito¹,

Fling

Chokephaibulkit

et al. 2020

Pediatric Infectious Disease Journal

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Background: Vaccination against seasonal influenza is recommended for all children with a history of medical conditions placing them at increased risk of influenza-associated complications. The immunogenicity and efficacy of conventional influenza vaccines among young children are suboptimal; one strategy to enhance these is adjuvantation. We present immunogenicity and safety data for an MF59-adjuvanted quadrivalent influenza vaccine (aIIV4) in healthy children and those at a high risk of influenza-associated complications, based on the results of a recently completed phase III study. Methods: Children 6 months to 5 years of age (N = 10,644) were enrolled. The study was conducted across northern hemisphere seasons 2013–2014 and 2014–2015. Subjects received either aIIV4 or a nonadjuvanted comparator influenza vaccine. Antibody responses were assessed by hemagglutination inhibition assay against vaccine and heterologous strains. Long-term antibody persistence was assessed (ClinicalTrials.gov: NCT01964989). Results: aIIV4 induced significantly higher antibody titers than nonadjuvanted vaccine in high-risk subjects. aIIV4 antibody responses were of similar magnitude in high-risk and healthy subjects. Incidence of solicited local and systemic adverse events (AEs) was slightly higher in aIIV4 than nonadjuvanted vaccinees, in both the healthy and high-risk groups. Incidence of unsolicited AEs, serious AEs and AEs of special interest were similar for adjuvanted and nonadjuvanted vaccinees in the healthy and high-risk groups. Conclusion: aIIV4 was more immunogenic than nonadjuvanted vaccine in both the healthy and high-risk study groups. The reactogenicity and safety profiles of aIIV4 and the nonadjuvanted vaccine were acceptable and similar in 6-month- to 5-year-old high-risk and healthy children.

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“…EDs are likely to be the first point of care for high-risk patients. In a recent retrospective analysis of laboratory-confirmed influenza cases in Serbia, Dimitrijević et al reported that at age over 65 years, the presence of any comorbidity (including chronic respiratory diseases, asthma, diabetes, chronic heart disease, CKD, neurological disease, immunocompromised status) or at least two comorbidities were among predictors of hospitalization or admission to ICU [46]. In our study we found that predictors of hospitalization in this study aligned with the increased risk of complication and may help physicians to recognize the predictors for hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Predictors and Outcomes of Hospitalization for Influenza: Real-World Evidence from the United States Medicare Population

Bolge

Kariburyo²,

Yüce

et al. 2020

Infect Dis Ther

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Introduction: The purpose of this study was to identify predictors of initial hospitalization and describe the outcomes of high-risk patients hospitalized with influenza. Methods: Data were taken from the 5% national US Medicare database from 2012 to 2015. Patients (aged at least 13 years) were required to have at least one diagnosis for influenza and have continuous health plan enrollment for 6 months before (baseline) and 3 months (follow-up) after the date of influenza diagnosis. Patients who died during follow-up were included. Patients were categorized as initially hospitalized if hospitalized within 0-1 day of diagnosis. High-risk initially hospitalized patients were defined as patients aged at least 65 years or those that had a diagnostic code for chronic lung disease, cardiovascular or cerebrovascular disease, or weakened immune system during baseline period. Logistic regression models were developed to determine predictors of initial hospitalization. Results: The study population included 8127 high-risk patients who were initially hospitalized and 16,784 who were not hospitalized. Among high-risk patients, 89.3% were diagnosed in the emergency room, whereas 7.5% and 3.2% were diagnosed in a physician's office or other Medicare settings, respectively. Chronic obstructive pulmonary disorder, congestive heart failure, chronic kidney disease, older age, being male, other comorbidities, number of comorbidities, and baseline healthcare resource use were the predictors of hospitalization. Median length of stay for the hospitalization was 5.0 days, and the 30-day readmission rate was 14%. All-cause mortality rate was 5.1% during the inpatient stay and 9.2% within 30 days of diagnosis. Hospitalized patients with influenza incurred an increase of $16,568 per patient in total all-cause healthcare costs from pre-influenza to post-influenza diagnosis. Conclusion: The study characterized the burden of hospitalization for influenza and found that hospitalized high-risk patients experience greater comorbidity burden, higher likelihood of multiple inpatient admissions, and costly Electronic supplementary material The online version of this article (

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Predictors of Hospitalization and Admission to Intensive Care Units of Influenza Patients in Serbia through Four Influenza Seasons from 2010/2011 to 2013/2014

Cited by 9 publications

References 14 publications

Surveillance Data for Eight Consecutive Influenza Seasons in Sicily, Italy

Surveillance Data for Eight Consecutive Influenza Seasons in Sicily, Italy

Immunogenicity and Safety of an MF59-adjuvanted Quadrivalent Seasonal Influenza Vaccine in Young Children at High Risk of Influenza-associated Complications: A Phase III, Randomized, Observer-blind, Multicenter Clinical Trial

Predictors and Outcomes of Hospitalization for Influenza: Real-World Evidence from the United States Medicare Population

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