Guesneau Charles, Boureau Anne Sophie, Bourigault Céline, Berrut Gilles, Lepelletier Didier, de Decker Laure, Chapelet Guillaume
Clinical Gerontology Department, Nantes University Hospital, 1 Place Alexis-Ricordeau, F-44000 Nantes, France.
Université de Nantes, EE MiHAR (Microbiotes, Hôtes, Antibiotiques et Résistance Bacterienne), Institut de Recherche en Santé (IRS2), 22 Boulevard Bénoni-Goullin, F-44200 Nantes, France.
J Clin Med. 2021 Aug 11;10(16):3521. doi: 10.3390/jcm10163521.
Influenza is a common viral condition, but factors related to short-term mortality have not been fully studied in older adults. Our objective was to determine whether there is an association between geriatric factors and 30-day mortality.
This was a retrospective cohort design. All patients aged 75 years and over, with a diagnosis of influenza confirmed by a positive RT-PCR, were included. The primary endpoint was death within the 30 days after diagnosis.
114 patients were included; 14 (12.3%) patients died within 30 days. In multivariate analysis these patients were older (OR: 1.37 95% CI (1.05, 1.79), = 0.021), and had a lower ADL score (OR: 0.36 95% CI (0, 17; 0.75), = 0.006), and a higher SOFA score (OR: 2.30 95% CI (1.07, 4.94), = 0.03). Oseltamivir treatment, initiated within the first 48 h, was independently associated with survival (OR: 0.04 95% CI (0.002, 0.78), = 0.034).
Identification of mortality risk factors makes it possible to consider specific secondary prevention measures such as the rapid introduction of antiviral treatment. Combined with primary prevention, these measures could help to limit the mortality associated with influenza in older patients.
流感是一种常见的病毒感染性疾病，但老年人短期死亡率相关因素尚未得到充分研究。我们的目的是确定老年因素与30天死亡率之间是否存在关联。
这是一项回顾性队列研究设计。纳入所有年龄在75岁及以上、经逆转录聚合酶链反应（RT-PCR）阳性确诊为流感的患者。主要终点是诊断后30天内死亡。
共纳入114例患者；14例（12.3%）患者在30天内死亡。多因素分析显示，这些患者年龄较大（比值比：1.37，95%置信区间（1.05，1.79），P = 0.021），日常生活活动能力（ADL）评分较低（比值比：0.36，95%置信区间（0.17，0.75），P = 0.006），序贯器官衰竭评估（SOFA）评分较高（比值比：2.30，95%置信区间（1.07，4.94），P = 0.03）。在发病48小时内开始使用奥司他韦治疗与生存独立相关（比值比：0.04，95%置信区间（0.002，0.78），P = 0.034）。
识别死亡风险因素有助于考虑采取特定的二级预防措施，如迅速启动抗病毒治疗。结合一级预防，这些措施有助于降低老年患者流感相关死亡率。
