From the Department of Epidemiology, Center for Communicable Disease Dynamics, Harvard TH Chan School of Public Health, Boston, MA.
Vaccines Division, Merck & Co., Inc., Kenilworth, NJ.
Epidemiology. 2019 Nov;30(6):918-926. doi: 10.1097/EDE.0000000000001092.
There is uncertainty about the burden of hospitalization associated with respiratory syncytial virus (RSV) and influenza in children, including those with underlying medical conditions.
We applied previously developed methodology to Health Care Cost and Utilization Project hospitalization data and additional data related to asthma diagnosis/previous history in hospitalized children to estimate RSV and influenza-associated hospitalization rates in different subpopulations of US children between 2003 and 2010.
The estimated average annual rates (per 100,000 children) of RSV-associated hospitalization with a respiratory cause (ICD-9 codes 460-519) present anywhere in the discharge diagnosis were 2,381 (95% CI(2252,2515)) in children <1 year of age; 710.6 (609.1, 809.2) (1 y old); 395 (327.7, 462.4) (2 y old); 211.3 (154.6, 266.8) (3 y old); 111.1 (62.4, 160.1) (4 y old); 72.3 (29.3, 116.4) (5-6 y of age); 35.6 (9.9,62.2) (7-11 y of age); and 39 (17.5, 60.6) (12-17 y of age). The corresponding rates of influenza-associated hospitalization were lower, ranging from 181 (142.5, 220.3) in <1 year old to 17.9 (11.7, 24.2) in 12-17 years of age. The relative risks for RSV-related hospitalization associated with a prior diagnosis of asthma in age groups <5 y ranged between 3.1 (2.1, 4.7) (<1 y old) and 6.7 (4.2, 11.8) (2 y old; the corresponding risks for influenza-related hospitalization ranged from 2.8 (2.1, 4) (<1y old) to 4.9 (3.8, 6.4) (3 y old).
RSV-associated hospitalization rates in young children are high and decline rapidly with age. There are additional risks for both RSV and influenza hospitalization associated with a prior diagnosis of asthma, with the rates of RSV-related hospitalization in the youngest children diagnosed with asthma being particularly high.
目前尚不确定与呼吸道合胞病毒（RSV）和流感相关的住院负担，包括患有基础疾病的儿童。
我们应用先前开发的方法，结合卫生保健成本和利用项目住院数据以及与住院儿童哮喘诊断/既往病史相关的其他数据，来估计 2003 年至 2010 年间美国不同年龄段儿童的 RSV 和流感相关住院率。
估计的 RSV 相关住院率（每 10 万儿童）与呼吸道病因（ICD-9 编码 460-519）在出院诊断中存在于任何部位的平均年率为：＜1 岁儿童 2381（95%CI（2252，2515））；1 岁儿童 710.6（609.1，809.2）；2 岁儿童 395（327.7，462.4）；3 岁儿童 211.3（154.6，266.8）；4 岁儿童 111.1（62.4，160.1）；5-6 岁儿童 72.3（29.3，116.4）；7-11 岁儿童 35.6（9.9，62.2）；12-17 岁儿童 39（17.5，60.6）。流感相关住院率较低，＜1 岁儿童为 181（142.5，220.3），12-17 岁儿童为 17.9（11.7，24.2）。＜5 岁儿童中哮喘既往诊断与 RSV 相关住院风险的相对危险度为 3.1（2.1，4.7）（＜1 岁）至 6.7（4.2，11.8）（2 岁）；流感相关住院风险的相应风险为 2.8（2.1，4）（＜1 岁）至 4.9（3.8，6.4）（3 岁）。
幼儿的 RSV 相关住院率较高，且随年龄增长迅速下降。哮喘既往诊断与 RSV 和流感住院相关的风险增加，诊断患有哮喘的最小年龄儿童的 RSV 相关住院率特别高。
