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Adlhoch C, Gomes Dias J, Bonmarin I, Hubert B, Larrauri A, Oliva Domínguez JA, Delgado-Sanz C, Brytting M, Carnahan A, Popovici O, Lupulescu E, O'Donnell J, Domegan L, Van Gageldonk-Lafeber AB, Meijer A, Kynčl J, Slezák P, Guiomar R, Orta Gomes CM, Popow-Kraupp T, Mikas J, Staroňová E, Melillo JM, Melillo T, Ikonen N, Lyytikäinen O, Snacken R, Penttinen P. Determinants of Fatal Outcome in Patients Admitted to Intensive Care Units With Influenza, European Union 2009-2017. Open Forum Infect Dis 2019; 6:ofz462. [PMID: 32258201 PMCID: PMC7105050 DOI: 10.1093/ofid/ofz462] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 10/23/2019] [Indexed: 01/13/2023] Open
Abstract
Background Morbidity, severity, and mortality associated with annual influenza epidemics are of public health concern. We analyzed surveillance data on hospitalized laboratory-confirmed influenza cases admitted to intensive care units to identify common determinants for fatal outcome and inform and target public health prevention strategies, including risk communication. Methods We performed a descriptive analysis and used Poisson regression models with robust variance to estimate the association of age, sex, virus (sub)type, and underlying medical condition with fatal outcome using European Union data from 2009 to 2017. Results Of 13 368 cases included in the basic dataset, 2806 (21%) were fatal. Age ≥40 years and infection with influenza A virus were associated with fatal outcome. Of 5886 cases with known underlying medical conditions and virus A subtype included in a more detailed analysis, 1349 (23%) were fatal. Influenza virus A(H1N1)pdm09 or A(H3N2) infection, age ≥60 years, cancer, human immunodeficiency virus infection and/or other immune deficiency, and heart, kidney, and liver disease were associated with fatal outcome; the risk of death was lower for patients with chronic lung disease and for pregnant women. Conclusions This study re-emphasises the importance of preventing influenza in the elderly and tailoring strategies to risk groups with underlying medical conditions.
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Affiliation(s)
- Cornelia Adlhoch
- Surveillance and Response Support, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Joana Gomes Dias
- Surveillance and Response Support, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | | | - Bruno Hubert
- Bruno Hubert, Santé Public France, Saint-Maurice Cedex, France
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Jesús A Oliva Domínguez
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Mia Brytting
- The Public Health Agency of Sweden, Solna, Sweden
| | | | - Odette Popovici
- National Institute of Public Health, Romania National Centre for Communicable Diseases Surveillance and Control, Bucuresti, Romania
| | - Emilia Lupulescu
- National Institute of Public Health, Romania National Centre for Communicable Diseases Surveillance and Control, Bucuresti, Romania
| | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Jan Kynčl
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic
| | - Pavel Slezák
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic
| | - Raquel Guiomar
- Instituto Nacional de Saúde Doutor Ricardo Jorge (National Institute of Health Dr. Ricardo Jorge), Lisboa, Portugal
| | - Carlos M Orta Gomes
- Department of Public Health of Regional Health Administration of Lisbon and Tagus Valley, Lisboa, Portugal
| | | | - Ján Mikas
- Public Health Authority of the Slovak Republic, Bratislava, Slovakia
| | - Edita Staroňová
- Public Health Authority of the Slovak Republic, Bratislava, Slovakia
| | - Jackie M Melillo
- Infectious Disease Prevention and Control Unit, Health Regulation, Malta
| | - Tanya Melillo
- Infectious Disease Prevention and Control Unit, Health Regulation, Malta
| | - Niina Ikonen
- Department of Health Security, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Outi Lyytikäinen
- Department of Health Security, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - René Snacken
- Surveillance and Response Support, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Pasi Penttinen
- Office of the Chief Scientist, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
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