Harrington Lauriane, Aris Emmanuel, Bhavsar Amit, Jamet Nicolas, Akpo Essè Ifèbi Hervé, Simeone Jason C, Ramond Anna, Lambrelli Dimitra, Oppenheimer John, Sergerie Yan, Mukherjee Piyali, Meszaros Kinga
GSK, Wavre, Belgium.
Evidera Inc., Waltham, MA, USA.
Infect Dis Ther. 2023 Apr;12(4):1103-1118. doi: 10.1007/s40121-023-00774-5. Epub 2023 Mar 16.
Pertussis, a highly infectious respiratory disease caused by Bordetella pertussis, affects people of all ages. Older adults are particularly susceptible to its severe outcomes and complications.
In this retrospective cohort study, the incidence rate of pertussis among individuals aged ≥ 50 years was assessed during 2009-2018 using Clinical Practice Research Datalink and Hospital Episode Statistics databases, United Kingdom. Health care resource utilisation (HCRU) and direct medical costs (DMCs) were compared between patients with a pertussis diagnosis and propensity score-matched controls (matched on demographic and clinical variables).
Among 5,222,860 individuals, 1638 had a pertussis diagnosis (incidence rate: 5.8 per 100,000 person-years; 95% confidence interval 5.5-6.0). Baseline (- 18 to - 6 months) HCRU and DMC were similar among 1480 pertussis patients and 1480 matched controls. However, there were increases in HCRU in the pertussis vs. matched cohort around the pertussis diagnosis (from months - 6 to - 1 to 5-11). The most notable increases (pertussis vs. controls) were in the rates of general practitioner (GP)/nurse visits (4.7-fold), clinical assessments (4.1-fold), and accident and emergency visits (3.0-fold) during the month before diagnosis and GP/nurse visits during the 2 months after diagnosis (2.5-fold) (all p < 0.001). DMCs were significantly higher in the pertussis cohort (p < 0.001). Total excess DMC in the pertussis cohort during months - 1 to + 11 was £318 per patient.
A pertussis diagnosis among adults aged ≥ 50 years resulted in significant increases in HCRU and DMC across several months around diagnosis. These results highlight the need for increased awareness of pertussis infection among adults aged ≥ 50 years and suggest that pertussis booster doses among this population should be considered.
百日咳是一种由百日咳博德特氏菌引起的高度传染性呼吸道疾病，影响所有年龄段的人群。老年人尤其易患其严重后果和并发症。
在这项回顾性队列研究中，利用英国临床实践研究数据链和医院 Episode 统计数据库评估了 2009 年至 2018 年期间年龄≥50 岁个体的百日咳发病率。比较了百日咳诊断患者与倾向评分匹配对照（根据人口统计学和临床变量匹配）之间的医疗保健资源利用（HCRU）和直接医疗费用（DMC）。
在 5222860 名个体中，1638 人被诊断为百日咳（发病率：每 10 万人年 5.8 例；95%置信区间 5.5 - 6.0）。1480 名百日咳患者和 1480 名匹配对照的基线（-18 至 -6 个月）HCRU 和 DMC 相似。然而，在百日咳诊断前后（从 -6 个月至 -1 个月到 5 - 11 个月），百日咳队列的 HCRU 有所增加。最显著的增加（百日咳患者与对照相比）是在诊断前一个月的全科医生（GP）/护士就诊率（4.7 倍）、临床评估率（4.1 倍）和急诊就诊率（3.0 倍）以及诊断后 2 个月内GP/护士就诊率（2.5 倍）（所有 p < 0.001）。百日咳队列的 DMC 显著更高（p < 0.001）。百日咳队列在 -1 至 +11 个月期间每位患者的总额外 DMC 为 318 英镑。
年龄≥50 岁的成年人百日咳诊断导致诊断前后数月的 HCRU 和 DMC 显著增加。这些结果凸显了提高对年龄≥50 岁成年人百日咳感染认识的必要性，并表明应考虑在该人群中接种百日咳加强疫苗。
