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Rates of Influenza-Associated Hospitalization, Intensive Care Unit Admission, and In-Hospital Death by Race and Ethnicity in the United States From 2009 to 2019.
O'Halloran, Alissa C; Holstein, Rachel; Cummings, Charisse; Daily Kirley, Pam; Alden, Nisha B; Yousey-Hindes, Kimberly; Anderson, Evan J; Ryan, Patricia; Kim, Sue; Lynfield, Ruth; McMullen, Chelsea; Bennett, Nancy M; Spina, Nancy; Billing, Laurie M; Sutton, Melissa; Schaffner, William; Talbot, H Keipp; Price, Andrea; Fry, Alicia M; Reed, Carrie; Garg, Shikha.
Affiliation
  • O'Halloran AC; Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Holstein R; Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Cummings C; Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Daily Kirley P; Abt Associates, Rockville, Maryland.
  • Alden NB; California Emerging Infections Program, Oakland.
  • Yousey-Hindes K; Communicable Disease Branch, Colorado Department of Public Health and Environment, Denver.
  • Anderson EJ; Connecticut Emerging Infections Program, Yale School of Public Health, New Haven.
  • Ryan P; Departments of Medicine and Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
  • Kim S; Emerging Infections Program, Georgia Department of Health, Atlanta.
  • Lynfield R; Veterans Affairs Medical Center, Atlanta, Georgia.
  • McMullen C; Maryland Department of Health, Baltimore.
  • Bennett NM; Communicable Disease Division, Michigan Department of Health and Human Services, Lansing.
  • Spina N; Minnesota Department of Health, St. Paul.
  • Billing LM; New Mexico Department of Health, Santa Fe.
  • Sutton M; University of Rochester School of Medicine and Dentistry, Rochester, New York.
  • Schaffner W; New York State Department of Health, Albany.
  • Talbot HK; Bureau of Infectious Diseases, Ohio Department of Health, Columbus.
  • Price A; Public Health Division, Oregon Health Authority, Portland.
  • Fry AM; Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee.
  • Reed C; Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee.
  • Garg S; Salt Lake County Health Department, Salt Lake City, Utah.
JAMA Netw Open ; 4(8): e2121880, 2021 08 02.
Article in En | MEDLINE | ID: mdl-34427679
Importance: Racial and ethnic minority groups, such as Black, Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons, often experience higher rates of severe influenza disease. Objective: To describe rates of influenza-associated hospitalization, intensive care unit (ICU) admission, and in-hospital death by race and ethnicity over 10 influenza seasons. Design, Setting, and Participants: This cross-sectional study used data from the Influenza-Associated Hospitalization Surveillance Network (FluSurv-NET), which conducts population-based surveillance for laboratory-confirmed influenza-associated hospitalizations in selected counties, representing approximately 9% of the US population. Influenza hospitalizations from the 2009 to 2010 season to the 2018 to 2019 season were analyzed. Data were analyzed from October 2020 to July 2021. Main Outcomes and Measures: The main outcomes were age-adjusted and age-stratified rates of influenza-associated hospitalization, ICU admission, and in-hospital death by race and ethnicity overall and by influenza season. Results: Among 113 352 persons with an influenza-associated hospitalization (34 436 persons [32.0%] aged ≥75 years; 61 009 [53.8%] women), 70 225 persons (62.3%) were non-Hispanic White (White), 24 850 persons (21.6%) were non-Hispanic Black (Black), 11 903 persons (10.3%) were Hispanic, 5517 persons (5.1%) were non-Hispanic Asian or Pacific Islander, and 857 persons (0.7%) were non-Hispanic American Indian or Alaska Native. Among persons aged younger than 75 years and compared with White persons of the same ages, Black persons were more likely to be hospitalized (eg, age 50-64 years: rate ratio [RR], 2.50 95% CI, 2.43-2.57) and to be admitted to an ICU (eg, age 50-64 years: RR, 2.09; 95% CI, 1.96-2.23). Among persons aged younger than 50 years and compared with White persons of the same ages, American Indian or Alaska Native persons were more likely to be hospitalized (eg, age 18-49 years: RR, 1.72; 95% CI, 1.51-1.96) and to be admitted to an ICU (eg, age 18-49 years: RR, 1.84; 95% CI, 1.40-2.42). Among children aged 4 years or younger and compared with White children, hospitalization rates were higher in Black children (RR, 2.21; 95% CI, 2.10-2.33), Hispanic children (RR, 1.87; 95% CI, 1.77-1.97), American Indian or Alaska Native children (RR, 3.00; 95% CI, 2.55-3.53), and Asian or Pacific Islander children (RR, 1.26; 95% CI, 1.16-1.38), as were rates of ICU admission (Black children: RR, 2.74; 95% CI, 2.43-3.09; Hispanic children: RR, 1.96; 95% CI, 1.73-2.23; American Indian and Alaska Native children: RR, 3.51; 95% CI, 2.45-5.05). In this age group and compared with White children, in-hospital death rates were higher among Hispanic children (RR, 2.98; 95% CI, 1.23-7.19), Black children (RR, 3.39; 95% CI, 1.40-8.18), and Asian or Pacific Islander children (RR, 4.35; 95% CI, 1.55-12.22). Few differences were observed in rates of severe influenza-associated outcomes by race and ethnicity among adults aged 75 years or older. For example, in this age group, compared with White adults, hospitalization rates were slightly higher only among Black adults (RR, 1.05; 95% CI 1.02-1.09). Overall, Black persons had the highest age-adjusted hospitalization rate (68.8 [95% CI, 68.0-69.7] hospitalizations per 100 000 population) and ICU admission rate (11.6 [95% CI, 11.2-11.9] admissions per 100 000 population). Conclusions and Relevance: This cross-sectional study found racial and ethnic disparities in rates of severe influenza-associated disease. These data identified subgroups for whom improvements in influenza prevention efforts could be targeted.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Patient Admission / Ethnicity / Hospital Mortality / Influenza, Human / Race Factors / Intensive Care Units Type of study: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Aspects: Determinantes_sociais_saude Limits: Adolescent / Adult / Aged / Aged80 / Child / Child, preschool / Female / Humans / Infant / Male Country/Region as subject: America do norte Language: En Journal: JAMA Netw Open Year: 2021 Document type: Article Affiliation country: Georgia Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Patient Admission / Ethnicity / Hospital Mortality / Influenza, Human / Race Factors / Intensive Care Units Type of study: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Aspects: Determinantes_sociais_saude Limits: Adolescent / Adult / Aged / Aged80 / Child / Child, preschool / Female / Humans / Infant / Male Country/Region as subject: America do norte Language: En Journal: JAMA Netw Open Year: 2021 Document type: Article Affiliation country: Georgia Country of publication: United States