IQVIA, Courbevoie, France.
Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (Inserm), Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.
Influenza Other Respir Viruses. 2022 Jul;16(4):717-725. doi: 10.1111/irv.12962. Epub 2022 Jan 10.
In France, each year, influenza viruses are responsible for seasonal epidemics leading to 2-6 million cases. Influenza can cause severe disease that may lead to hospitalization or death. As severe disease may be due to the virus itself or to disease complications, estimating the burden of severe influenza is complex. The present study aimed at estimating the epidemiological and economic burden of severe influenza in France during eight consecutive influenza seasons (2010-2018).
Influenza-related hospitalization and mortality data and patient characteristics were taken from the French hospital information database, PMSI. An ecological approach using cyclic regression models integrating the incidence of influenza syndrome from the Sentinelles network supplemented the PMSI data analysis in estimating excess hospitalization and mortality (CépiDc-2010-2015) and medical costs.
Each season, the average number of influenza-related hospitalizations was 18,979 (range: 8627-44,024), with an average length of stay of 8 days. The average number of respiratory hospitalizations indirectly related with influenza (i.e., influenza associated) was 31,490 (95% confidence interval [CI]: 24,542-39,012), with an average cost of €141 million (range: 54-217); 70% of these hospitalizations and 77% of their costs concerned individuals ≥65 years of age (65+). More than 90% of excess mortality was in 65+ subjects.
The combination of two complementary approaches allowed estimation of both influenza-related and associated hospitalizations and deaths and their burden in France, showing the substantial impact of complications. The present study highlighted the major public health burden of influenza and its severe complications, especially in 65+ subjects.
在法国，每年流感病毒都会引发季节性流行，导致 200 万至 600 万例病例。流感可导致严重疾病，可能导致住院或死亡。由于严重疾病可能是由病毒本身引起的，也可能是由疾病并发症引起的，因此评估严重流感的负担较为复杂。本研究旨在估计法国连续 8 个流感季节（2010-2018 年）期间严重流感的流行病学和经济负担。
流感相关住院和死亡率数据以及患者特征来自法国医院信息数据库 PMSI。使用循环回归模型的生态方法，整合 Sentinelles 网络中流感综合征的发病率，补充 PMSI 数据分析，以估计超额住院和死亡率（CépiDc-2010-2015）和医疗费用。
每个季节，与流感相关的住院人数平均为 18979 人（范围：8627-44024 人），平均住院时间为 8 天。与流感间接相关的呼吸道住院人数（即流感相关）平均为 31490 人（95%置信区间 [CI]：24542-39012 人），平均费用为 1.41 亿欧元（范围：5400-2170 万欧元）；这些住院治疗中有 70%和 77%的费用与≥65 岁的患者有关（65+）。超过 90%的超额死亡率发生在 65+人群中。
两种互补方法的结合可用于估计法国的流感相关和相关住院和死亡人数及其负担，显示出并发症的巨大影响。本研究强调了流感及其严重并发症对公共卫生的重大负担，尤其是在 65+人群中。
