College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia; Department of General Medicine, Division of Medicine, Cardiac & Critical Care, Flinders Medical Centre, Adelaide, South Australia, Australia.
Department of Clinical Epidemiology, Flinders Medical Centre, Adelaide, South Australia, Australia.
Int J Infect Dis. 2021 Mar;104:232-238. doi: 10.1016/j.ijid.2021.01.011. Epub 2021 Jan 9.
Worldwide, seasonal influenza causes significant mortality and poses a significant economic burden. Oseltamivir is an effective treatment, but benefits beyond immediate hospitalization are unknown.
This retrospective multicenter study included adult hospitalized influenza patients from two major teaching hospitals in Australia. Patients who received Oseltamivir <48 h of admission (prompt-treatment group) were compared with those who either did not receive treatment or if treatment was delayed by >48 h (delayed/no-treatment group). Propensity-score matching was used to balance confounders between two groups. Primary outcomes included 30-day readmissions, 30-day mortality, composite-outcome (30-day mortality and readmissions), in-hospital mortality, and hospital length of stay (LOS).
Between January 2016-March 2020, 1828 adult patients mean (SD) age 66.4 (20.1), 52.9% females, were hospitalized with influenza. Four hundred and forty-eight (24.5%) received prompt-treatment with Oseltamivir, while 1380 (75.5%) patients were in the delayed/no-treatment group. The median (IQR) time from onset of symptoms to the administration of Oseltamivir was three (1-5) days. The propensity-score model included 245 matched patients in each group (standardized mean difference of <10%). Both 30-day readmissions and the composite-outcome were, respectively, 5.7% (P = 0.03) and 6.5% (P = 0.02) lower in patients who received prompt-treatment with Oseltamivir when compared to the delayed/no-treatment group. LOS showed a significant reduction, and in-hospital mortality showed a trend towards improvement among patients who received prompt-treatment when compared to the other group.
Early administration of Oseltamivir was associated with a reduction in 30-days readmissions and composite-outcome of 30-day readmissions and mortality in adult hospitalized influenza patients when compared to delayed/no-treatment.
在全球范围内，季节性流感会导致大量死亡，并造成巨大的经济负担。奥司他韦是一种有效的治疗药物，但在住院之外的获益尚不清楚。
这是一项回顾性多中心研究，纳入了来自澳大利亚两家主要教学医院的成年流感住院患者。将入院 48 小时内接受奥司他韦治疗的患者（及时治疗组）与未接受治疗或治疗延迟超过 48 小时的患者（延迟/未治疗组）进行比较。采用倾向评分匹配来平衡两组间的混杂因素。主要结局包括 30 天再入院、30 天死亡率、复合结局（30 天死亡率和再入院）、住院期间死亡率和住院时间（LOS）。
2016 年 1 月至 2020 年 3 月，1828 例成年流感住院患者，平均（标准差）年龄 66.4（20.1）岁，52.9%为女性。448 例（24.5%）患者接受了奥司他韦及时治疗，1380 例（75.5%）患者为延迟/未治疗组。从症状出现到给予奥司他韦治疗的中位数（IQR）时间为 3（1-5）天。倾向评分模型中，每组各纳入 245 例匹配患者（标准化均差 <10%）。与延迟/未治疗组相比，及时接受奥司他韦治疗的患者 30 天再入院率和复合结局（30 天再入院和死亡率）分别低 5.7%（P=0.03）和 6.5%（P=0.02）。与其他组相比，及时接受奥司他韦治疗的患者 LOS 显著缩短，住院期间死亡率也有改善趋势。
与延迟/未治疗组相比，在成年流感住院患者中，及早给予奥司他韦治疗与 30 天再入院率和复合结局（30 天再入院和死亡率）降低相关。
