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2009 年甲型 H1N1 流感住院患者死亡率的风险因素分析,亚利桑那州马里科帕县,2009 年 4 月至 2010 年 3 月。

Risk factors for mortality among 2009 A/H1N1 influenza hospitalizations in Maricopa County, Arizona, April 2009 to March 2010.

机构信息

School of Human Evolution and Social Change, Arizona State University, Tempe, AZ 85287, USA.

出版信息

Comput Math Methods Med. 2012;2012:914196. doi: 10.1155/2012/914196. Epub 2012 Jul 15.

Abstract

We analyzed individual-level data on pandemic influenza A/H1N1pdm hospitalizations from the enhanced surveillance system of the Maricopa County Department of Public Health, AZ, USA from April 1st, 2009 to March 31st, 2010. We also assessed the the risk of death among A/H1N1 hospitalizations using multivariate logistic regression. Hospitalization rates were significantly higher among Native Americans (risk ratio (RR)  =  6.2; 95% CI: 6.15, 6.21), non-Hispanic Black (RR = 3.84; 95% CI: 3.8, 3.9), and Hispanics (RR = 2.0; 95% CI: 2.0, 2.01) compared to non-Hispanic Whites. Throughout the spring, 59.2% of hospitalized patients received antiviral treatment; the proportion of patients treated increased significantly during the fall to 74.4% (Chi-square test, P < 0.0001). In our best-fit logistic model, the adjusted risk of death among A/H1N1 inpatients was significantly higher during the fall wave (August 16, 2009 to March 31, 2010, OR = 3.94; 95% CI: 1.72, 9.03) compared to the spring wave (April 1, 2009 to August 15, 2009). Moreover, chronic lung disease (OR = 3.5; 95% CI: 1.7, 7.4), cancer within the last 12 months (OR = 4.3; 95%CI: 1.3, 14.8), immuno-suppression (OR = 4.0; 95% CI: 1.84, 8.9), and admission delays (OR = 4.6; 95% CI: 2.2, 9.5) were significantly associated with an increased the risk of death among A/H1N1 inpatients.

摘要

我们分析了 2009 年 4 月 1 日至 2010 年 3 月 31 日美国亚利桑那州马里科帕县公共卫生部加强监测系统中甲型 H1N1pdm 流感住院患者的个体数据。我们还使用多变量逻辑回归评估了甲型 H1N1 住院患者的死亡风险。与非西班牙裔白人相比,美国原住民(风险比 (RR) = 6.2;95%置信区间:6.15,6.21)、非西班牙裔黑人(RR = 3.84;95%置信区间:3.8,3.9)和西班牙裔(RR = 2.0;95%置信区间:2.0,2.01)的住院率显著更高。整个春季,59.2%的住院患者接受了抗病毒治疗;秋季接受治疗的患者比例显著增加至 74.4%(卡方检验,P < 0.0001)。在我们的最佳拟合逻辑模型中,甲型 H1N1 住院患者秋季波(2009 年 8 月 16 日至 2010 年 3 月 31 日)的死亡风险调整后显著高于春季波(2009 年 4 月 1 日至 2009 年 8 月 15 日)(OR = 3.94;95%CI:1.72,9.03)。此外,慢性肺病(OR = 3.5;95%CI:1.7,7.4)、过去 12 个月内癌症(OR = 4.3;95%CI:1.3,14.8)、免疫抑制(OR = 4.0;95%CI:1.84,8.9)和住院时间延迟(OR = 4.6;95%CI:2.2,9.5)与甲型 H1N1 住院患者的死亡风险增加显著相关。

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