Owusu Daniel, Rolfes Melissa A, Arriola Carmen S, Daily Kirley Pam, Alden Nisha B, Meek James, Anderson Evan J, Monroe Maya L, Kim Sue, Lynfield Ruth, Angeles Kathy, Spina Nancy, Felsen Christina B, Billing Laurie, Thomas Ann, Keipp Talbot H, Schaffner William, Chatelain Ryan, Reed Carrie, Garg Shikha
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Open Forum Infect Dis. 2022 Mar 16;9(5):ofac131. doi: 10.1093/ofid/ofac131. eCollection 2022 May.
Diabetes mellitus (DM) is common among older adults hospitalized with influenza, yet data are limited on the impact of DM on risk of severe influenza-associated outcomes.
We included adults aged ≥65 years hospitalized with influenza during 2012-2013 through 2016-2017 from the Influenza Hospitalization Surveillance Network (FluSurv-NET), a population-based surveillance system for laboratory-confirmed influenza-associated hospitalizations conducted in defined counties within 13 states. We calculated population denominators using the Centers for Medicare and Medicaid Services county-specific DM prevalence estimates and National Center for Health Statistics population data. We present pooled rates and rate ratios (RRs) of intensive care unit (ICU) admission, pneumonia diagnosis, mechanical ventilation, and in-hospital death for persons with and without DM. We estimated RRs and 95% confidence intervals (CIs) using meta-analysis with site as a random effect in order to control for site differences in the estimates.
Of 31 934 hospitalized adults included in the analysis, 34% had DM. Compared to those without DM, adults with DM had higher rates of influenza-associated hospitalization (RR, 1.57 [95% CI, 1.43-1.72]), ICU admission (RR, 1.84 [95% CI, 1.67-2.04]), pneumonia (RR, 1.57 [95% CI, 1.42-1.73]), mechanical ventilation (RR, 1.95 [95% CI, 1.74-2.20]), and in-hospital death (RR, 1.48 [95% CI, 1.23-1.80]).
Older adults with DM have higher rates of severe influenza-associated outcomes compared to those without DM. These findings reinforce the importance of preventing influenza virus infections through annual vaccination, and early treatment of influenza illness with antivirals in older adults with DM.
糖尿病（DM）在因流感住院的老年人中很常见，但关于DM对严重流感相关结局风险的影响的数据有限。
我们纳入了2012 - 2013年至2016 - 2017年期间因流感住院的≥65岁成年人，这些数据来自流感住院监测网络（FluSurv-NET），这是一个基于人群的监测系统，用于在13个州内特定县进行实验室确诊的流感相关住院病例监测。我们使用医疗保险和医疗补助服务中心特定县的DM患病率估计值以及国家卫生统计中心的人口数据来计算人口分母。我们给出了有和没有DM的人群的重症监护病房（ICU）入院、肺炎诊断、机械通气和院内死亡的合并率及率比（RRs）。我们使用以地点为随机效应的荟萃分析来估计RRs和95%置信区间（CIs），以控制估计中的地点差异。
在纳入分析的31934名住院成年人中，34%患有DM。与没有DM的成年人相比，患有DM的成年人流感相关住院率更高（RR，1.57 [95% CI，1.43 - 1.72]）、ICU入院率更高（RR，1.84 [95% CI，1.67 - 2.04]）、肺炎发生率更高（RR，1.57 [95% CI，1.42 - 1.73]）、机械通气率更高（RR，1.95 [95% CI，1.74 - 2.20]）以及院内死亡率更高（RR，1.48 [95% CI，1.23 - 1.80]）。
与没有DM的老年人相比，患有DM的老年人严重流感相关结局的发生率更高。这些发现强化了通过年度疫苗接种预防流感病毒感染以及对患有DM的老年人使用抗病毒药物早期治疗流感疾病的重要性。
