Impact of influenza related hospitalization in Spain: characteristics and risk factor of mortality during five influenza seasons (2016 to 2021)
BackgroundEstimating the global influenza burden in terms of hospitalization and death is important for optimizing prevention policies. Identifying risk factors for mortality allows for the design of strategies tailored to groups at the highest risk. This study aims to (a) describe the clinical char...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-04-01
|
| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1360372/full |
| _version_ | 1827299196226502656 |
|---|---|
| author | José-Manuel Ramos-Rincón Héctor Pinargote-Celorio Pilar González-de-la-Aleja José Sánchez-Payá Sergio Reus Juan-Carlos Rodríguez-Díaz Esperanza Merino |
| author_facet | José-Manuel Ramos-Rincón Héctor Pinargote-Celorio Pilar González-de-la-Aleja José Sánchez-Payá Sergio Reus Juan-Carlos Rodríguez-Díaz Esperanza Merino |
| author_sort | José-Manuel Ramos-Rincón |
| collection | DOAJ |
| description | BackgroundEstimating the global influenza burden in terms of hospitalization and death is important for optimizing prevention policies. Identifying risk factors for mortality allows for the design of strategies tailored to groups at the highest risk. This study aims to (a) describe the clinical characteristics of hospitalizations with a diagnosis of influenza over five flu seasons (2016–2017 to 2020–2021), (b) assess the associated morbidity (hospitalization rates and ICU admissions rate), mortality and cost of influenza hospitalizations in different age groups and (c) analyze the risk factors for mortality.MethodsThis retrospective study included all hospital admissions with a diagnosis of influenza in Spain for five influenza seasons. Data were extracted from the Spanish National Surveillance System for Hospital Data from 1 July 2016 to 30 June 2021. We identified cases coded as having influenza as a primary or secondary diagnosis (International Classification of Diseases, 10th revision, J09-J11). The hospitalization rate was calculated relative to the general population. Independent predictors of mortality were identified using multivariable logistic regression.ResultsOver the five seasons, there were 127,160 hospitalizations with a diagnosis of influenza. The mean influenza hospitalization rate varied from 5/100,000 in 2020–2021 (COVID-19 pandemic) to 92.9/100,000 in 2017–2018. The proportion of influenza hospitalizations with ICU admission was 7.4% and was highest in people aged 40–59 years (13.9%). The case fatality rate was 5.8% overall and 9.4% in those aged 80 years or older. Median length of stay was 5 days (and 6 days in the oldest age group). In the multivariable analysis, independent risk factors for mortality were male sex (odds ratio [OR] 1.14, 95% confidence interval [95% CI] 1.08–1.20), age (<5 years: OR 1; 5–19 years: OR 2.02, 95%CI 1.17–3.49; 20–39 years: OR 4.11, 95% CI 2.67–6.32; 40–59 years: OR 8.15, 95% CI 5.60–11.87; 60–79 years: OR 15.10, 95% CI 10.44–21.84; ≥80 years: OR 33.41, 95% CI 23.10–48.34), neurological disorder (OR 1.97, 95% CI 1.83–2.11), heart failure (OR 1.85, 95% CI 1.74–1.96), chronic kidney disease (OR 1.33, 95% CI 1.25–1.41), chronic liver disease (OR 2.95, 95% CI 2.68–3.27), cancer (OR 1.85, 95% CI 1.48–2.24), coinfection with SARS-CoV2 (OR 3.17, 95% CI 2.34–4.28), influenza pneumonia (OR 1.76, 95% CI 1.66–1.86) and admission to intensive care (OR 7.81, 95% CI 7.31–8.36).ConclusionInfluenza entails a major public health burden. People aged over 60—and especially those over 80—show the longest hospital stays. Age is also the most significant risk factor for mortality, along with certain associated comorbidities. |
| first_indexed | 2024-04-24T15:29:55Z |
| format | Article |
| id | doaj.art-69c66d2b53a54329981195ade474e2fa |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-24T15:29:55Z |
| publishDate | 2024-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-69c66d2b53a54329981195ade474e2fa2024-04-02T04:43:44ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-04-011210.3389/fpubh.2024.13603721360372Impact of influenza related hospitalization in Spain: characteristics and risk factor of mortality during five influenza seasons (2016 to 2021)José-Manuel Ramos-Rincón0Héctor Pinargote-Celorio1Pilar González-de-la-Aleja2José Sánchez-Payá3Sergio Reus4Juan-Carlos Rodríguez-Díaz5Esperanza Merino6Internal Medicine Department, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, SpainUnit of Infectious Diseases, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, SpainUnit of Infectious Diseases, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, SpainPreventive Service, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, SpainUnit of Infectious Diseases, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, SpainMicrobiology Service, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, SpainUnit of Infectious Diseases, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, SpainBackgroundEstimating the global influenza burden in terms of hospitalization and death is important for optimizing prevention policies. Identifying risk factors for mortality allows for the design of strategies tailored to groups at the highest risk. This study aims to (a) describe the clinical characteristics of hospitalizations with a diagnosis of influenza over five flu seasons (2016–2017 to 2020–2021), (b) assess the associated morbidity (hospitalization rates and ICU admissions rate), mortality and cost of influenza hospitalizations in different age groups and (c) analyze the risk factors for mortality.MethodsThis retrospective study included all hospital admissions with a diagnosis of influenza in Spain for five influenza seasons. Data were extracted from the Spanish National Surveillance System for Hospital Data from 1 July 2016 to 30 June 2021. We identified cases coded as having influenza as a primary or secondary diagnosis (International Classification of Diseases, 10th revision, J09-J11). The hospitalization rate was calculated relative to the general population. Independent predictors of mortality were identified using multivariable logistic regression.ResultsOver the five seasons, there were 127,160 hospitalizations with a diagnosis of influenza. The mean influenza hospitalization rate varied from 5/100,000 in 2020–2021 (COVID-19 pandemic) to 92.9/100,000 in 2017–2018. The proportion of influenza hospitalizations with ICU admission was 7.4% and was highest in people aged 40–59 years (13.9%). The case fatality rate was 5.8% overall and 9.4% in those aged 80 years or older. Median length of stay was 5 days (and 6 days in the oldest age group). In the multivariable analysis, independent risk factors for mortality were male sex (odds ratio [OR] 1.14, 95% confidence interval [95% CI] 1.08–1.20), age (<5 years: OR 1; 5–19 years: OR 2.02, 95%CI 1.17–3.49; 20–39 years: OR 4.11, 95% CI 2.67–6.32; 40–59 years: OR 8.15, 95% CI 5.60–11.87; 60–79 years: OR 15.10, 95% CI 10.44–21.84; ≥80 years: OR 33.41, 95% CI 23.10–48.34), neurological disorder (OR 1.97, 95% CI 1.83–2.11), heart failure (OR 1.85, 95% CI 1.74–1.96), chronic kidney disease (OR 1.33, 95% CI 1.25–1.41), chronic liver disease (OR 2.95, 95% CI 2.68–3.27), cancer (OR 1.85, 95% CI 1.48–2.24), coinfection with SARS-CoV2 (OR 3.17, 95% CI 2.34–4.28), influenza pneumonia (OR 1.76, 95% CI 1.66–1.86) and admission to intensive care (OR 7.81, 95% CI 7.31–8.36).ConclusionInfluenza entails a major public health burden. People aged over 60—and especially those over 80—show the longest hospital stays. Age is also the most significant risk factor for mortality, along with certain associated comorbidities.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1360372/fullinfluenzaepidemicsSpainhospitalizationsmortalityintensive care unit |
| spellingShingle | José-Manuel Ramos-Rincón Héctor Pinargote-Celorio Pilar González-de-la-Aleja José Sánchez-Payá Sergio Reus Juan-Carlos Rodríguez-Díaz Esperanza Merino Impact of influenza related hospitalization in Spain: characteristics and risk factor of mortality during five influenza seasons (2016 to 2021) Frontiers in Public Health influenza epidemics Spain hospitalizations mortality intensive care unit |
| title | Impact of influenza related hospitalization in Spain: characteristics and risk factor of mortality during five influenza seasons (2016 to 2021) |
| title_full | Impact of influenza related hospitalization in Spain: characteristics and risk factor of mortality during five influenza seasons (2016 to 2021) |
| title_fullStr | Impact of influenza related hospitalization in Spain: characteristics and risk factor of mortality during five influenza seasons (2016 to 2021) |
| title_full_unstemmed | Impact of influenza related hospitalization in Spain: characteristics and risk factor of mortality during five influenza seasons (2016 to 2021) |
| title_short | Impact of influenza related hospitalization in Spain: characteristics and risk factor of mortality during five influenza seasons (2016 to 2021) |
| title_sort | impact of influenza related hospitalization in spain characteristics and risk factor of mortality during five influenza seasons 2016 to 2021 |
| topic | influenza epidemics Spain hospitalizations mortality intensive care unit |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1360372/full |
| work_keys_str_mv | AT josemanuelramosrincon impactofinfluenzarelatedhospitalizationinspaincharacteristicsandriskfactorofmortalityduringfiveinfluenzaseasons2016to2021 AT hectorpinargotecelorio impactofinfluenzarelatedhospitalizationinspaincharacteristicsandriskfactorofmortalityduringfiveinfluenzaseasons2016to2021 AT pilargonzalezdelaaleja impactofinfluenzarelatedhospitalizationinspaincharacteristicsandriskfactorofmortalityduringfiveinfluenzaseasons2016to2021 AT josesanchezpaya impactofinfluenzarelatedhospitalizationinspaincharacteristicsandriskfactorofmortalityduringfiveinfluenzaseasons2016to2021 AT sergioreus impactofinfluenzarelatedhospitalizationinspaincharacteristicsandriskfactorofmortalityduringfiveinfluenzaseasons2016to2021 AT juancarlosrodriguezdiaz impactofinfluenzarelatedhospitalizationinspaincharacteristicsandriskfactorofmortalityduringfiveinfluenzaseasons2016to2021 AT esperanzamerino impactofinfluenzarelatedhospitalizationinspaincharacteristicsandriskfactorofmortalityduringfiveinfluenzaseasons2016to2021 |