New Mexico Department of Health, Santa Fe, USA.
Am J Public Health. 2011 Sep;101(9):1776-84. doi: 10.2105/AJPH.2011.300223. Epub 2011 Jul 21.
We assessed risk factors for 2009 pandemic influenza A (H1N1)-related hospitalization, mechanical ventilation, and death among New Mexico residents.
We calculated population rate ratios using Poisson regression to analyze risk factors for H1N1-related hospitalization. We performed a cross-sectional analysis of hospitalizations during September 14, 2009 through January 13, 2010, using logistic regression to assess risk factors for mechanical ventilation and death among those hospitalized.
During the study period, 926 laboratory-confirmed H1N1-related hospitalizations were identified. H1N1-related hospitalization was significantly higher among American Indians (risk ratio [RR] = 2.6; 95% confidence interval [CI] = 2.2, 3.2), Blacks (RR = 1.7; 95% CI = 1.2, 2.4), and Hispanics (RR = 1.8; 95% CI = 1.5, 2.0) than it was among non-Hispanic Whites, and also was higher among persons of younger age and lower household income. Mechanical ventilation was significantly associated with age 25 years and older, obesity, and lack of or delayed antiviral treatment. Death was significantly associated with male gender, cancer during the previous 12 months, and liver disorder.
This analysis supports recent national efforts to include American Indian/Alaska Native race as a group at high risk for complications of influenza with respect to vaccination and antiviral treatment recommendations.
我们评估了新墨西哥州居民中与 2009 年甲型 H1N1 流感相关住院、机械通气和死亡的危险因素。
我们使用泊松回归计算了人口率比值，以分析与 H1N1 相关的住院的危险因素。我们使用逻辑回归对 2009 年 9 月 14 日至 2010 年 1 月 13 日期间的住院情况进行了横断面分析，以评估住院患者中机械通气和死亡的危险因素。
在研究期间，共确定了 926 例经实验室确诊的与 H1N1 相关的住院病例。与非西班牙裔白人相比，美国印第安人（风险比 [RR] = 2.6；95%置信区间 [CI] = 2.2, 3.2）、黑人和西班牙裔（RR = 1.7；95% CI = 1.2, 2.4）中 H1N1 相关住院的发生率明显更高，且年龄较小和家庭收入较低的人群中 H1N1 相关住院的发生率也较高。机械通气与年龄 25 岁及以上、肥胖以及缺乏或延迟使用抗病毒治疗显著相关。死亡与男性、过去 12 个月期间患有癌症以及肝脏疾病显著相关。
该分析支持最近在全国范围内努力将美洲印第安人/阿拉斯加原住民作为一个高风险群体，在流感疫苗接种和抗病毒治疗建议方面予以考虑。
