Association of age and comorbidity on 2009 influenza a pandemic H1N1-related intensive care unit stay in Massachusetts

H.E.D. Placzek and L.C. Madoff

American Journal of Public Health, 2014, vol. 104, issue 11, e118-e125

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. © 2014, American Public Health Association Inc. All rights reserved.

Keywords: adolescent; adult; age; asthma; child; comorbidity; epidemiology; female; human; Influenza virus A H1N1; Influenza, Human; intensive care unit; middle aged; pandemic; pregnancy; Pregnancy Complications, Infectious; preschool child; risk factor; statistical model; statistics and numerical data; United States; young adult, Adolescent; Adult; Age Factors; Asthma; Child; Child, Preschool; Comorbidity; Female; Humans; Influenza A Virus, H1N1 Subtype; Influenza, Human; Intensive Care Units; Logistic Models; Massachusetts; Middle Aged; Pandemics; Pregnancy; Pregnancy Complications, Infectious; Risk Factors; Young Adult (search for similar items in EconPapers)
Date: 2014
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2014.302197_3

DOI: 10.2105/AJPH.2014.302197

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