Association of Age and Comorbidity on 2009 Influenza A Pandemic H1N1-Related Intensive Care Unit Stay in Massachusetts
- 1 November 2014
- journal article
- Published by American Public Health Association in American Journal of Public Health
- Vol. 104 (11), e118-e125
- https://doi.org/10.2105/ajph.2014.302197
Abstract
Objectives. We compared comorbidity measures by age group and risk factors for influenza-like illness (ILI)–related intensive care unit (ICU) stay during the 2009 seasonal influenza and influenza A (pH1N1) pandemic. Methods. We identified all patients discharged from Massachusetts hospitals with ILI-related diagnoses between October 1, 2008, and April 25, 2009, and pH1N1–related diagnoses between April 26 and September 30, 2009. We calculated the Diagnostic Cost Group (DxCG) risk score as a measure of comorbidity. We used logistic regression predictive models to compare ICU stay predictors. Results. Mean DxCG scores were similar for pH1N1 and seasonal influenza time periods (0.69 and 0.70). Compared with those aged 45 to 64 years, patients younger than 5, 5 to 12, and 13 to 18 years had an increased risk of pH1N1-related ICU stay. Within the pH1N1 cohort, an asthma diagnosis was highly predictive of ICU admission among those younger than 5, 5 to 12, and 13 to 18 years, and pregnancy among those aged 26 to 44 years. Conclusion. High-risk groups, including children with asthma or pregnant women, would benefit from improved surveillance and resource allocation during influenza outbreaks to prevent serious ILI-related complications.Keywords
This publication has 22 references indexed in Scilit:
- Age- and Sex-related Risk Factors for Influenza-associated Mortality in the United States Between 1997–2007American Journal of Epidemiology, 2013
- Mechanisms of sex disparities in influenza pathogenesisJournal of Leukocyte Biology, 2012
- Age-Dependent Patterns of Infection and Severity Explaining the Low Impact of 2009 Influenza A (H1N1): Evidence From Serial Serologic Surveys in the NetherlandsAmerican Journal of Epidemiology, 2011
- Children With Asthma Hospitalized With Seasonal or Pandemic Influenza, 2003–2009PEDIATRICS, 2011
- Complications and Outcomes of Pandemic 2009 Influenza A (H1N1) Virus Infection in Hospitalized Adults: How Do They Differ From Those in Seasonal Influenza?The Journal of Infectious Diseases, 2011
- High frequency of cross-reacting antibodies against 2009 pandemic influenza A(H1N1) virus among the elderly in FinlandEurosurveillance, 2010
- Update: influenza activity--United States, August 30, 2009-January 9, 2010.2010
- Hospitalized Patients with 2009 H1N1 Influenza in the United States, April–June 2009The New England Journal of Medicine, 2009
- Code-based Syndromic Surveillance for Influenzalike Illness by International Classification of Diseases, Ninth RevisionEmerging Infectious Diseases, 2007
- Risk Adjustment of Medicare Capitation Payments Using the CMS-HCC Model2004