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Publications

Journal Article Epublish 18 citations

PubMed: 35450083 DOI: 10.1093/ofid/ofac131

Rates of Severe Influenza-Associated Outcomes Among Older Adults Living With Diabetes-Influenza Hospitalization Surveillance Network (FluSurv-NET), 2012-2017.

Open Forum Infect Dis 9(5):ofac131

Authors: Daniel Owusu, Melissa A Rolfes, Carmen S Arriola, Pam Daily Kirley, Nisha B Alden, James Meek, Evan J Anderson, Maya L Monroe, Sue Kim, Ruth Lynfield, Kathy Angeles, Nancy Spina, Christina B Felsen, Laurie Billing, Ann Thomas, H Keipp Talbot, William Schaffner, Ryan Chatelain, Carrie Reed, Shikha Garg

Affiliations

  • Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • California Emerging Infections Program, Oakland, California, USA.
  • Colorado Department of Public Health and Environment, Denver, Colorado, USA.
  • Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut, USA.
  • Department of Medicine and Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Georgia Emerging Infections Program, Georgia Department of Health, Atlanta, Georgia, USA.
  • Atlanta Veterans Affairs Medical Center, Atlanta, Georgia, USA.
  • Maryland Department of Health, Baltimore, Maryland, USA.
  • Michigan Department of Health and Human Services, Lansing, Michigan, USA.
  • Minnesota Department of Health, St Paul, Minnesota, USA.
  • New Mexico Department of Health, Santa Fe, New Mexico, USA.
  • New York State Department of Health, Albany, New York, USA.
  • University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
  • Ohio Department of Health, Columbus, Ohio, USA.
  • Oregon Public Health Authority, Portland, Oregon, USA.
  • Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
  • Salt Lake County Health Department, Salt Lake City, Utah, USA.

Abstract

Background

Diabetes mellitus (DM) is common among older adults hospitalized with influenza, yet data are limited on the impact of DM on risk of severe influenza-associated outcomes.

Methods

We included adults aged ≥65 years hospitalized with influenza during 2012-2013 through 2016-2017 from the Influenza Hospitalization Surveillance Network (FluSurv-NET), a population-based surveillance system for laboratory-confirmed influenza-associated hospitalizations conducted in defined counties within 13 states. We calculated population denominators using the Centers for Medicare and Medicaid Services county-specific DM prevalence estimates and National Center for Health Statistics population data. We present pooled rates and rate ratios (RRs) of intensive care unit (ICU) admission, pneumonia diagnosis, mechanical ventilation, and in-hospital death for persons with and without DM. We estimated RRs and 95% confidence intervals (CIs) using meta-analysis with site as a random effect in order to control for site differences in the estimates.

Results

Of 31 934 hospitalized adults included in the analysis, 34% had DM. Compared to those without DM, adults with DM had higher rates of influenza-associated hospitalization (RR, 1.57 [95% CI, 1.43-1.72]), ICU admission (RR, 1.84 [95% CI, 1.67-2.04]), pneumonia (RR, 1.57 [95% CI, 1.42-1.73]), mechanical ventilation (RR, 1.95 [95% CI, 1.74-2.20]), and in-hospital death (RR, 1.48 [95% CI, 1.23-1.80]).

Conclusions

Older adults with DM have higher rates of severe influenza-associated outcomes compared to those without DM. These findings reinforce the importance of preventing influenza virus infections through annual vaccination, and early treatment of influenza illness with antivirals in older adults with DM.

MeSH

Diabetes Mellitus, Hospitalization, Pneumonia, Influenza, Human, Intensive Care Units, Ventilation

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