Excess hospitalizations and mortality associated with seasonal influenza in Spain, 2008–2018

BMC Infectious Diseases

Research

T. Pumarola¹  M. Carmo²  G. Bizouard³  E. Redondo Margüello⁴  A. Gil-de-Miguel⁵  J. L. López-Belmonte⁶  G. Drago⁶  H. Bricout⁷  C. de Courville⁷  F. Martinón-Torres⁸  J. Díez-Domingo⁹  R. Ortiz de Lejarazu Leonardo^1,10 

[1] Department of Microbiology, Hospital Universitari Vall d’Hebron, Barcelona, Spain;Universitat Autònoma de Barcelona, Plaça Cívica, 08193, Bellaterra, Barcelona, Spain;IQVIA, Barcelona, Spain;IQVIA, Paris, France;International Health Center Madrid Health, City Council of Madrid, Madrid, Spain;Public Health and Medical Specialties Department, Health Sciences Faculty, Juan Carlos University, Madrid, Spain;Sanofi, Barcelona, Spain;Sanofi, Lyon, France;Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario and Universidad de Santiago de Compostela, Galicia, Spain;Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago and Universidad de Santiago de Compostela (USC), Galicia, Spain;Consorcio Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain;Vaccine Research Department, University of Valencia, Valencia, Spain;Valladolid National Influenza Centre, Hospital Clínico Universitario de Valladolid, Valladolid, Spain;

关键词: Influenza;    Burden;    Excess;    Mortality;    Hospitalization;    Cardiovascular;    Respiratory;    Spain;   

DOI  :  10.1186/s12879-023-08015-3

 received in 2022-07-03, accepted in 2023-01-18,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundInfluenza may trigger complications, particularly in at-risk groups, potentially leading to hospitalization or death. However, due to lack of routine testing, influenza cases are infrequently coded with influenza-specific diagnosis. Statistical models using influenza activity as an explanatory variable can be used to estimate annual hospitalizations and deaths associated with influenza. Our study aimed to estimate the clinical and economic burden of severe influenza in Spain, considering such models.MethodsThe study comprised ten epidemic seasons (2008/2009–2017/2018) and used two approaches: (i) a direct method of estimating the seasonal influenza hospitalization, based on the number of National Health Service hospitalizations with influenza-specific International Classification of Diseases (ICD) codes (ICD-9: 487–488; ICD-10: J09-J11), as primary or secondary diagnosis; (ii) an indirect method of estimating excess hospitalizations and deaths using broader groups of ICD codes in time-series models, computed for six age groups and four groups of diagnoses: pneumonia or influenza (ICD-9: 480–488, 517.1; ICD-10: J09–J18), respiratory (ICD-9: 460–519; ICD-10: J00–J99), respiratory or cardiovascular (C&R, ICD-9: 390–459, 460–519; ICD-10: I00–I99, J00–J99), and all-cause. Means, excluding the H1N1pdm09 pandemic (2009/2010), are reported in this study.ResultsThe mean number of hospitalizations with a diagnosis of influenza per season was 13,063, corresponding to 28.1 cases per 100,000 people. The mean direct annual cost of these hospitalizations was €45.7 million, of which 65.7% was generated by patients with comorbidities. Mean annual influenza-associated C&R hospitalizations were estimated at 34,894 (min: 16,546; max: 52,861), corresponding to 75.0 cases per 100,000 (95% confidence interval [CI]: 63.3–86.3) for all ages and 335.3 (95% CI: 293.2–377.5) in patients aged ≥ 65 years. We estimate 3.8 influenza-associated excess C&R hospitalizations for each hospitalization coded with an influenza-specific diagnosis in patients aged ≥ 65 years. The mean direct annual cost of the estimated excess C&R hospitalizations was €142.9 million for all ages and €115.9 million for patients aged ≥ 65 years. Mean annual influenza-associated all-cause mortality per 100,000 people was estimated at 27.7 for all ages.ConclusionsResults suggest a relevant under-detected burden of influenza mostly in the elderly population, but not neglectable in younger people.

【 授权许可】

CC BY   
© The Author(s) 2023

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