Placzek Hilary, Madoff Larry
Doctoral Candidate in Clinical and Population Health Research at UMass Medical School and Division of Infectious Diseases and Immunology, University of Massachusetts Medical School. Division of Epidemiology and Immunization, Massachusetts Department of Public Health. ProMED-mail, International Society for Infectious Diseases.
PLoS Curr. 2011 Aug 14;3:RRN1256. doi: 10.1371/currents.RRN1256.
Objectives(1) To characterize the epidemiology of H1N1-related hospitalizations in Massachusetts; and (2) to compare characteristics of those hospitalized during periods of seasonal influenza activity and during the H1N1 pandemic. MethodsAuthors applied maximum and minimum criteria to the Massachusetts Hospital Discharge Database to identify H1N1-related hospitalizations. They constructed annual line graphs describing mean frequencies of influenza-like illness(ILI)-related discharges between 2005-2008, and compared these rates to early waves of H1N1 in 2009. ResultsDuring spring and summer 2009, there were significantly higher rates of ILI-related hospital discharges in Massachusetts compared to 2005-2008. Out of 359,344 total discharges between April 26-September 30,2009, H1N1-related hospitalizations ranged from 601 to 10,967 cases. Minimum criteria confirmed that H1N1 affected a younger population (50% were <18 years), with higher rates among African-Americans (18%) and Hispanics (23%) and higher rates of ICU admission (21%) compared to seasonal influenza (39%, 10%, 14%, and 17% respectively). ConclusionsThis is the first population-based assessment of epidemiological characteristics of hospitalized H1N1 cases in Massachusetts, and it is the first to include all possible hospitalized cases in the analysis. The authors confirm that large administrative data sets can detect hospitalizations for influenza during a pandemic, but estimated case counts vary widely depending on selection criteria used. Maximum criteria overestimated H1N1 activity, and those meeting minimum criteria resemble published accounts of H1N1-related hospitalizations closely.
（1）描述马萨诸塞州甲型H1N1流感相关住院病例的流行病学特征；（2）比较季节性流感活动期间和甲型H1N1流感大流行期间住院患者的特征。方法：作者对马萨诸塞州医院出院数据库应用最大和最小标准来确定甲型H1N1流感相关住院病例。他们绘制了2005 - 2008年期间流感样疾病（ILI）相关出院平均频率的年度折线图，并将这些比率与2009年甲型H1N1流感的早期波峰进行比较。结果：2009年春夏季节，马萨诸塞州ILI相关医院出院率显著高于2005 - 2008年。在2009年4月26日至9月30日期间的359,344例出院病例中，甲型H1N1流感相关住院病例数在601至10,967例之间。最小标准证实甲型H1N1流感影响的人群更年轻（50%小于18岁），非裔美国人（18%）和西班牙裔（23%）的发病率更高，与季节性流感相比，入住重症监护病房（ICU）的比例也更高（分别为21%和39%、10%、14%和17%）。结论：这是对马萨诸塞州甲型H1N1流感住院病例流行病学特征的首次基于人群的评估，也是首次在分析中纳入所有可能的住院病例。作者证实大型行政数据集可在大流行期间检测到流感住院病例，但估计病例数因所使用的选择标准而异。最大标准高估了甲型H1N1流感的活动情况，而符合最小标准的情况与已发表的甲型H1N1流感相关住院病例描述非常相似。
