Risk factors for in-hospital mortality and secondary bacterial pneumonia among hospitalized adult patients with community-acquired influenza: a large retrospective cohort study

作者全名："Yi, Guangzhao; de Kraker, Marlieke E. A.; Buetti, Niccolo; Zhong, Xiaoni; Li, Jinyan; Yuan, Zhe; Zhu, Weimin; Zhou, Jia; Zhou, Hongyu"

作者地址："[Yi, Guangzhao; Yuan, Zhe; Zhou, Hongyu] Chongqing Med Univ, Dept Hosp Infect Control, Affiliated Hosp 1, You Yi Rd 1, Chongqing 400016, Peoples R China; [de Kraker, Marlieke E. A.; Buetti, Niccolo] Geneva Univ Hosp, Fac Med, Infect Control Program, Geneva, Switzerland; [Zhong, Xiaoni; Zhou, Hongyu] Chongqing Med Univ, Res Ctr Med & Social Dev, Sch Publ Hlth, Chongqing, Peoples R China; [Li, Jinyan] Chongqing Med Univ, Informat Ctr, Affiliated Hosp 1, Chongqing, Peoples R China; [Yuan, Zhe; Zhu, Weimin] Chongqing Med Univ, Dept Infect Dis, Affiliated Hosp 1, Chongqing, Peoples R China; [Zhou, Jia] Chongqing Med Univ, Dept Pulm & Crit Care Med, Affiliated Hosp 1, Chongqing, Peoples R China; [Yi, Guangzhao; Zhu, Weimin] Chongqing Med Univ, Dept Dis Prevent & Hlth Protect, Affiliated Hosp 1, Chongqing, Peoples R China"

通信作者："Zhou, HY (通讯作者)，Chongqing Med Univ, Dept Hosp Infect Control, Affiliated Hosp 1, You Yi Rd 1, Chongqing 400016, Peoples R China.; Zhou, HY (通讯作者)，Chongqing Med Univ, Res Ctr Med & Social Dev, Sch Publ Hlth, Chongqing, Peoples R China."

来源：ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL

ESI学科分类：PHARMACOLOGY & TOXICOLOGY

WOS号：WOS:000961231600001

JCR分区：Q1

影响因子：4.8

年份：2023

卷号：12

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Risk factors; Seasonal influenza; Secondary bacterial pneumonia; All-cause in-hospital mortality

摘要："BackgroundSecondary bacterial pneumonia is an important complication of seasonal influenza, but little data is available about impact on death and risk factors. This study identified risk factors for all-cause in-hospital mortality and secondary bacterial pneumonia among hospitalized adult patients with community-acquired influenza.MethodsA retrospective cohort study was performed at a tertiary teaching hospital in southwest China. The study cohort included all adult hospitalized patients with a laboratory-confirmed, community-acquired influenza virus infection during three consecutive influenza seasons from 2017 to 2020. Cause-specific Cox regression was used to analyze risk factors for mortality and secondary bacterial pneumonia, respectively, accounting for competing events (discharge alive and discharge alive or death without secondary bacterial pneumonia, respectively).ResultsAmong 174 patients enrolled in this study, 14.4% developed secondary bacterial pneumonia and 11.5% died during hospitalization. For all-cause in-hospital mortality, time-varying secondary bacterial pneumonia was a direct risk factor of death (cause-specific hazard ratio [csHR] 3.38, 95% confidence interval [CI] 1.25-9.17); underlying disease indirectly increased death risk through decreasing the hazard of being discharged alive (csHR 0.55, 95% CI 0.39-0.77). For secondary bacterial pneumonia, the final model only confirmed direct risk factors: age >= 65 years (csHR 2.90, 95% CI 1.27-6.62), male gender (csHR 3.78, 95% CI 1.12-12.84) and mechanical ventilation on admission (csHR 2.96, 95% CI 1.32-6.64).ConclusionsSecondary bacterial pneumonia was a major risk factor for in-hospital mortality among adult hospitalized patients with community-acquired influenza. Prevention strategies for secondary bacterial pneumonia should target elderly male patients and critically ill patients under mechanical ventilation."

基金机构：Chongqing Federation of Social Science [2020PY48]; Chongqing Science and Technology Bureau; Chongqing Health Commission of China [2020FYYX005]

基金资助正文：The Chongqing Social Science Planning Project which is funded by Chongqing Federation of Social Science (Grant Number 2020PY48). The Joint Project of Chongqing Science and Technology Bureau and Health Commission which is funded by Chongqing Science and Technology Bureau and Chongqing Health Commission of China (Grant Number 2020FYYX005).