Lapi Francesco, Marconi Ettore, Rossi Alessandro, Cricelli Claudio
Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy.
Italian College of General Practitioners and Primary Care, Florence, Italy.
Fam Pract. 2024 Apr 15;41(2):76-85. doi: 10.1093/fampra/cmae009.
Viral infections are the main original cause of recurrent respiratory tract infections (RRTIs), but their complications and recurrences are due to bacteria as well. While some operational definitions and epidemiology of RRTIs are reported in paediatrics, no similar definitions have been proposed for adults.
To assess the epidemiology and characteristics of RRTIs in the adult population.
Cohort study in the primary care setting.
Using the Health Search Database, we selected a cohort of patients aged 18 years or older between 2002 and 2022. Yearly, we counted upper and lower respiratory tract infections (RTIs) per patient. We investigated 2 cut-offs defining RRTIs, nominally 3+ RRTIs/patient/year or greater than the mean value of RTIs/patient/year. The associations between these two event definitions and the correlates defining the patients' vulnerability were assessed by estimating a logistic regression model.
Over the study years, the mean number of RTIs/patient/year ranged from 0.07-0.16 or 1.10-1.13 events, when the denominator was formed by the overall population or those diagnosed with RTIs, respectively. When the analysis was focussed on 2022, we obtained 0.2% (1.3% among those with RTIs) or 13% (11.3% among those with RTIs) cases of RRTIs, using a cut-off of 3+ or >=0.16 events (mean value/patient), respectively. Consistent associations were found for these two operational definitions and the investigated clinical correlates.
We provided evidence on the epidemiology and concurrent/predisposing factors of RRTIs in adults. These data should support health authorities and general practitioners for the application of the most appropriate preventive and/or treatment strategies.
病毒感染是反复呼吸道感染（RRTIs）的主要原始病因，但其并发症和复发也与细菌有关。虽然儿科领域报道了一些RRTIs的操作定义和流行病学情况，但尚未针对成年人提出类似定义。
评估成年人群中RRTIs的流行病学情况和特征。
基层医疗环境中的队列研究。
利用健康搜索数据库，我们选取了2002年至2022年间18岁及以上的患者队列。每年，我们统计每位患者的上呼吸道和下呼吸道感染（RTIs）次数。我们研究了定义RRTIs的两个临界值，名义上为每位患者每年3次及以上RRTIs或高于每位患者每年RTIs的平均值。通过估计逻辑回归模型评估这两种事件定义与定义患者易感性的相关因素之间的关联。
在研究期间，当分母分别为总体人群或被诊断为RTIs的人群时，每位患者每年RTIs的平均次数在0.07 - 0.16次或1.10 - 1.13次之间波动。当分析聚焦于2022年时，使用3次及以上或≥0.16次事件（平均值/患者）的临界值，我们分别得到了0.2%（在患有RTIs的人群中为1.3%）或13%（在患有RTIs的人群中为11.3%）的RRTIs病例。这两种操作定义与所研究的临床相关因素之间存在一致的关联。
我们提供了关于成年人RRTIs的流行病学以及并发/易感因素的证据。这些数据应有助于卫生当局和全科医生应用最合适的预防和/或治疗策略。
