Newall Anthony T, Wood James G, Macintyre C Raina
The School of Public Health, The University of Sydney, NSW, Australia.
Vaccine. 2008 Apr 16;26(17):2135-41. doi: 10.1016/j.vaccine.2008.01.051. Epub 2008 Feb 15.
Estimating the true burden of influenza is problematic because relatively few hospitalisations or deaths are specifically coded as influenza related. Statistical regression techniques using influenza and respiratory syncytial virus surveillance data were used to estimate the number of excess hospitalisations and deaths attributable to influenza. Several International Classification of Diseases 10th Revision (ICD-10) groupings were used for both hospitalisation and mortality estimates, including influenza and pneumonia, other respiratory disorders, and circulatory disorders. For Australians aged 50-64 years, the annual excess hospitalisations attributable to influenza were 33.3 (95%CI: 23.2-43.4) per 100,000 for influenza and pneumonia and 57.6 (95%CI: 32.5-82.8) per 100,000 for other respiratory disorders. For Australians aged > or =65 years, the annual excess hospitalisations attributable to influenza were 157.4 (95%CI: 108.4-206.5) per 100,000 for influenza and pneumonia and 282.0 (95%CI: 183.7-380.3) per 100,000 for other respiratory disorders. The annual excess all-cause mortality attributable to influenza was 6.4 (95%CI: 2.6-10.2) per 100,000 and 116.4 (95%CI: 71.3-161.5) per 100,000, for Australians aged 50-64 years and those aged > or =65 years, respectively. In the age-group > or =65 years, a significant association was found between influenza activity and circulatory mortality. We conclude that influenza is responsible for a substantial amount of mortality and morbidity, over and above that which is directly diagnosed as influenza in Australians aged > or =50 years.
估算流感的真实负担存在问题，因为相对较少的住院或死亡病例被明确编码为与流感相关。利用流感和呼吸道合胞病毒监测数据的统计回归技术，来估算可归因于流感的额外住院和死亡人数。住院和死亡率估算均使用了国际疾病分类第十版（ICD - 10）的几个分组，包括流感和肺炎、其他呼吸系统疾病以及循环系统疾病。对于50 - 64岁的澳大利亚人，每10万人中，因流感和肺炎导致的年度额外住院人数为33.3（95%置信区间：23.2 - 43.4），因其他呼吸系统疾病导致的为57.6（95%置信区间：32.5 - 82.8）。对于65岁及以上的澳大利亚人，每10万人中，因流感和肺炎导致的年度额外住院人数为157.4（95%置信区间：108.4 - 206.5），因其他呼吸系统疾病导致的为282.0（95%置信区间：183.7 - 380.3）。对于50 - 64岁和65岁及以上的澳大利亚人，每10万人中，因流感导致的年度额外全因死亡率分别为6.4（95%置信区间：2.6 - 10.2）和116.4（95%置信区间：71.3 - 161.5）。在65岁及以上年龄组中，发现流感活动与循环系统死亡率之间存在显著关联。我们得出结论，在50岁及以上的澳大利亚人中，流感导致了大量的死亡率和发病率，远超直接诊断为流感的病例数。
