Adlhoch Cornelia, Gomes Dias Joana, Bonmarin Isabelle, Hubert Bruno, Larrauri Amparo, Oliva Domínguez Jesús A, Delgado-Sanz Concepción, Brytting Mia, Carnahan Annasara, Popovici Odette, Lupulescu Emilia, O'Donnell Joan, Domegan Lisa, Van Gageldonk-Lafeber Arianne B, Meijer Adam, Kynčl Jan, Slezák Pavel, Guiomar Raquel, Orta Gomes Carlos M, Popow-Kraupp Theresia, Mikas Ján, Staroňová Edita, Melillo Jackie M, Melillo Tanya, Ikonen Niina, Lyytikäinen Outi, Snacken René, Penttinen Pasi
Surveillance and Response Support, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden.
Bruno Hubert, Santé Public France, Saint-Maurice Cedex, France.
Open Forum Infect Dis. 2019 Oct 29;6(11):ofz462. doi: 10.1093/ofid/ofz462. eCollection 2019 Nov.
Morbidity, severity, and mortality associated with annual influenza epidemics are of public health concern. We analyzed surveillance data on hospitalized laboratory-confirmed influenza cases admitted to intensive care units to identify common determinants for fatal outcome and inform and target public health prevention strategies, including risk communication.
We performed a descriptive analysis and used Poisson regression models with robust variance to estimate the association of age, sex, virus (sub)type, and underlying medical condition with fatal outcome using European Union data from 2009 to 2017.
Of 13 368 cases included in the basic dataset, 2806 (21%) were fatal. Age ≥40 years and infection with influenza A virus were associated with fatal outcome. Of 5886 cases with known underlying medical conditions and virus A subtype included in a more detailed analysis, 1349 (23%) were fatal. Influenza virus A(H1N1)pdm09 or A(H3N2) infection, age ≥60 years, cancer, human immunodeficiency virus infection and/or other immune deficiency, and heart, kidney, and liver disease were associated with fatal outcome; the risk of death was lower for patients with chronic lung disease and for pregnant women.
This study re-emphasises the importance of preventing influenza in the elderly and tailoring strategies to risk groups with underlying medical conditions.
每年流感流行所带来的发病率、严重程度和死亡率是公共卫生关注的问题。我们分析了重症监护病房收治的实验室确诊流感住院病例的监测数据，以确定导致致命结局的常见决定因素，并为公共卫生预防策略（包括风险沟通）提供信息并确定目标人群。
我们进行了描述性分析，并使用具有稳健方差的泊松回归模型，利用2009年至2017年的欧盟数据估计年龄、性别、病毒（亚）型和基础疾病与致命结局之间的关联。
在基础数据集中纳入的13368例病例中，2806例（21%）死亡。年龄≥40岁和感染甲型流感病毒与致命结局相关。在更详细分析中纳入的5886例已知基础疾病和甲型病毒亚型的病例中，1349例（23%）死亡。甲型H1N1pdm09或甲型H3N2流感病毒感染、年龄≥60岁、癌症、人类免疫缺陷病毒感染和/或其他免疫缺陷以及心、肾和肝脏疾病与致命结局相关；慢性肺病患者和孕妇的死亡风险较低。
本研究再次强调了预防老年人流感以及针对有基础疾病的风险人群制定策略的重要性。
