Hospital-onset influenza hospitalizations--United States, 2010-2011

Am J Infect Control. 2014 Jan;42(1):7-11. doi: 10.1016/j.ajic.2013.06.018. Epub 2013 Oct 30.

Abstract

Background: Seasonal influenza is responsible for more than 200,000 hospitalizations each year in the United States. Although hospital-onset (HO) influenza contributes to morbidity and mortality among these patients, little is known about its overall epidemiology.

Objective: We describe patients with HO influenza in the United States during the 2010-2011 influenza season and compare them with community-onset (CO) cases to better understand factors associated with illness.

Methods: We identified laboratory-confirmed, influenza-related hospitalizations using the Influenza Hospitalization Surveillance Network (FluSurv-NET), a network that conducts population-based surveillance in 16 states. CO cases had laboratory confirmation ≤ 3 days after hospital admission; HO cases had laboratory confirmation > 3 days after admission.

Results: We identified 172 (2.8%) HO cases among a total of 6,171 influenza-positive hospitalizations. HO and CO cases did not differ by age (P = .22), sex (P = .29), or race (P = .25). Chronic medical conditions were more common in HO cases (89%) compared with CO cases (78%) (P < .01), and a greater proportion of HO cases (42%) than CO cases (17%) were admitted to the intensive care unit (P < .01). The median length of stay after influenza diagnosis of HO cases (7.5 days) was greater than that of CO cases (3 days) (P < .01).

Conclusion: HO cases had greater length of stay and were more likely to be admitted to the intensive care unit or die compared with CO cases. HO influenza may play a role in the clinical outcome of hospitalized patients, particularly among those with chronic medical conditions.

Keywords: Health care associated.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / mortality
  • Community-Acquired Infections / pathology
  • Critical Care / statistics & numerical data
  • Cross Infection / epidemiology*
  • Cross Infection / mortality
  • Cross Infection / pathology
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Infant
  • Infant, Newborn
  • Influenza, Human / epidemiology*
  • Influenza, Human / mortality
  • Influenza, Human / pathology
  • Length of Stay
  • Male
  • Middle Aged
  • Survival Analysis
  • United States / epidemiology
  • Young Adult