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Clin Infect Dis. 2015 Dec 15;61(12):1807-14. doi: 10.1093/cid/civ733. Epub 2015 Sep 2.

Impact of Prompt Influenza Antiviral Treatment on Extended Care Needs After Influenza Hospitalization Among Community-Dwelling Older Adults.

Author information

1
Influenza Division, Centers for Disease Control and Prevention, Atlanta Georgia.
2
Colorado Department of Public Health and Environment, Denver.
3
Department of Medicine, University of Rochester School of Medicine and Dentistry, New York.
4
Rhode Island Department of Health, Providence.
5
Department of Medicine, Emory University School of Medicine, Atlanta Atlanta Veterans Affairs Medical Center, Georgia.
6
Ohio Department of Health, Columbus.
7
New Mexico Department of Health, Santa Fe.
8
California Emerging Infections Program, Oakland.
9
Minnesota Department of Health, St Paul.
10
Maryland Department of Health and Mental Hygiene, Baltimore.
11
Vanderbilt University School of Medicine, Nashville, Tennessee.
12
Michigan Department of Community Health, Lansing.
13
Idaho Department of Health and Welfare, Boise.
14
Oregon Public Health Division, Portland.
15
Salt Lake County Health Department, Utah.
16
Oklahoma State Department of Health, Oklahoma City.
17
Iowa Department of Public Health, Des Moines.
18
Connecticut Emerging Infections Program, Yale School of Public Health, New Haven.
19
Emerging Infections Program, New York State Department of Health, Albany.

Abstract

BACKGROUND:

Patients hospitalized with influenza may require extended care on discharge. We aimed to explore predictors for extended care needs and the potential mitigating effect of antiviral treatment among community-dwelling adults aged ≥ 65 years hospitalized with influenza.

METHODS:

We used laboratory-confirmed influenza hospitalizations from 3 influenza seasons. Extended care was defined as new placement in a skilled nursing home/long-term/rehabilitation facility on hospital discharge. We focused on those treated with antiviral agents to explore the effect of early treatment on extended care and hospital length of stay using logistic regression and competing risk survival analysis, accounting for time from illness onset to hospitalization. Treatment was categorized as early (≤ 4 days) or late (>4 days) in reference to date of illness onset.

RESULTS:

Among 6593 community-dwelling adults aged ≥ 65 years hospitalized for influenza, 18% required extended care at discharge. The need for care increased with age and neurologic disorders, intensive care unit admission, and pneumonia were predictors of care needs. Early treatment reduced the odds of extended care after hospital discharge for those hospitalized ≤ 2 or >2 days from illness onset (adjusted odds ratio, 0.38 [95% confidence interval {CI}, .17-.85] and 0.75 [.56-.97], respectively). Early treatment was also independently associated with reduction in length of stay for those hospitalized ≤ 2 days from illness onset (adjusted hazard ratio, 1.81; 95% CI, 1.43-2.30) or >2 days (1.30; 1.20-1.40).

CONCLUSIONS:

Prompt antiviral treatment decreases the impact of influenza on older adults through shorten hospitalization and reduced extended care needs.

KEYWORDS:

elderly; extended care; influenza; influenza antiviral treatment; influenza hospitalizations

PMID:
26334053
DOI:
10.1093/cid/civ733
[Indexed for MEDLINE]
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