Excess hospitalizations and mortality associated with seasonal influenza in Spain, 2008-2018

Background Influenza may trigger complications, particularly in at-risk groups, potentially leading to hospitalization or death. However, due to lack of routine testing, influenza cases are infrequently coded with influenza-specific diagnosis. Statistical models using influenza activity as an explan...

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Autores: Pumarola, T, Diez-Domingo, J, Martinon-Torres, F, Margueello, ER, Leonardo, ROD, Carmo, M, Bizouard, G, Drago, G, Lopez-Belmonte, JL, Bricout, H, De Courville, C, Gil-de-Miguel, A
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p15264
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/15264
Access Level:acceso abierto
Palabra clave:Influenza
Burden
Excess
Mortality
Hospitalization
Cardiovascular
Respiratory
Spain
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repository_id_str
spelling Excess hospitalizations and mortality associated with seasonal influenza in Spain, 2008-2018Pumarola, TDiez-Domingo, JMartinon-Torres, FMargueello, ERLeonardo, RODCarmo, MBizouard, GDrago, GLopez-Belmonte, JLBricout, HDe Courville, CGil-de-Miguel, AInfluenzaBurdenExcessMortalityHospitalizationCardiovascularRespiratorySpainBackground Influenza may trigger complications, particularly in at-risk groups, potentially leading to hospitalization or death. However, due to lack of routine testing, influenza cases are infrequently coded with influenza-specific diagnosis. Statistical models using influenza activity as an explanatory variable can be used to estimate annual hospitalizations and deaths associated with influenza. Our study aimed to estimate the clinical and economic burden of severe influenza in Spain, considering such models. Methods The study comprised ten epidemic seasons (2008/2009-2017/2018) and used two approaches: (i) a direct method of estimating the seasonal influenza hospitalization, based on the number of National Health Service hospitalizations with influenza-specific International Classification of Diseases (ICD) codes (ICD-9: 487-488; ICD-10: J09-J11), as primary or secondary diagnosis; (ii) an indirect method of estimating excess hospitalizations and deaths using broader groups of ICD codes in time-series models, computed for six age groups and four groups of diagnoses: pneumonia or influenza (ICD-9: 480-488, 517.1; ICD-10: J09-J18), respiratory (ICD-9: 460-519; ICD-10: J00-J99), respiratory or cardiovascular (C&R, ICD-9: 390-459, 460-519; ICD-10: I00-I99, J00-J99), and all-cause. Means, excluding the H1N1pdm09 pandemic (2009/2010), are reported in this study. Results The mean number of hospitalizations with a diagnosis of influenza per season was 13,063, corresponding to 28.1 cases per 100,000 people. The mean direct annual cost of these hospitalizations was (sic)45.7 million, of which 65.7% was generated by patients with comorbidities. Mean annual influenza-associated C&R hospitalizations were estimated at 34,894 (min: 16,546; max: 52,861), corresponding to 75.0 cases per 100,000 (95% confidence interval [CI]: 63.3-86.3) for all ages and 335.3 (95% CI: 293.2-377.5) in patients aged >= 65 years. We estimate 3.8 influenza-associated excess C&R hospitalizations for each hospitalization coded with an influenza-specific diagnosis in patients aged >= 65 years. The mean direct annual cost of the estimated excess C&R hospitalizations was (sic)142.9 million for all ages and (sic)115.9 million for patients aged >= 65 years. Mean annual influenza-associated all-cause mortality per 100,000 people was estimated at 27.7 for all ages. Conclusions Results suggest a relevant under-detected burden of influenza mostly in the elderly population, but not neglectable in younger people.BMC2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/15264BMC INFECTIOUS DISEASESISSN: 14712334reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p152642026-06-11T12:45:17Z
dc.title.none.fl_str_mv Excess hospitalizations and mortality associated with seasonal influenza in Spain, 2008-2018
title Excess hospitalizations and mortality associated with seasonal influenza in Spain, 2008-2018
spellingShingle Excess hospitalizations and mortality associated with seasonal influenza in Spain, 2008-2018
Pumarola, T
Influenza
Burden
Excess
Mortality
Hospitalization
Cardiovascular
Respiratory
Spain
title_short Excess hospitalizations and mortality associated with seasonal influenza in Spain, 2008-2018
title_full Excess hospitalizations and mortality associated with seasonal influenza in Spain, 2008-2018
title_fullStr Excess hospitalizations and mortality associated with seasonal influenza in Spain, 2008-2018
title_full_unstemmed Excess hospitalizations and mortality associated with seasonal influenza in Spain, 2008-2018
title_sort Excess hospitalizations and mortality associated with seasonal influenza in Spain, 2008-2018
dc.creator.none.fl_str_mv Pumarola, T
Diez-Domingo, J
Martinon-Torres, F
Margueello, ER
Leonardo, ROD
Carmo, M
Bizouard, G
Drago, G
Lopez-Belmonte, JL
Bricout, H
De Courville, C
Gil-de-Miguel, A
author Pumarola, T
author_facet Pumarola, T
Diez-Domingo, J
Martinon-Torres, F
Margueello, ER
Leonardo, ROD
Carmo, M
Bizouard, G
Drago, G
Lopez-Belmonte, JL
Bricout, H
De Courville, C
Gil-de-Miguel, A
author_role author
author2 Diez-Domingo, J
Martinon-Torres, F
Margueello, ER
Leonardo, ROD
Carmo, M
Bizouard, G
Drago, G
Lopez-Belmonte, JL
Bricout, H
De Courville, C
Gil-de-Miguel, A
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Influenza
Burden
Excess
Mortality
Hospitalization
Cardiovascular
Respiratory
Spain
topic Influenza
Burden
Excess
Mortality
Hospitalization
Cardiovascular
Respiratory
Spain
description Background Influenza may trigger complications, particularly in at-risk groups, potentially leading to hospitalization or death. However, due to lack of routine testing, influenza cases are infrequently coded with influenza-specific diagnosis. Statistical models using influenza activity as an explanatory variable can be used to estimate annual hospitalizations and deaths associated with influenza. Our study aimed to estimate the clinical and economic burden of severe influenza in Spain, considering such models. Methods The study comprised ten epidemic seasons (2008/2009-2017/2018) and used two approaches: (i) a direct method of estimating the seasonal influenza hospitalization, based on the number of National Health Service hospitalizations with influenza-specific International Classification of Diseases (ICD) codes (ICD-9: 487-488; ICD-10: J09-J11), as primary or secondary diagnosis; (ii) an indirect method of estimating excess hospitalizations and deaths using broader groups of ICD codes in time-series models, computed for six age groups and four groups of diagnoses: pneumonia or influenza (ICD-9: 480-488, 517.1; ICD-10: J09-J18), respiratory (ICD-9: 460-519; ICD-10: J00-J99), respiratory or cardiovascular (C&R, ICD-9: 390-459, 460-519; ICD-10: I00-I99, J00-J99), and all-cause. Means, excluding the H1N1pdm09 pandemic (2009/2010), are reported in this study. Results The mean number of hospitalizations with a diagnosis of influenza per season was 13,063, corresponding to 28.1 cases per 100,000 people. The mean direct annual cost of these hospitalizations was (sic)45.7 million, of which 65.7% was generated by patients with comorbidities. Mean annual influenza-associated C&R hospitalizations were estimated at 34,894 (min: 16,546; max: 52,861), corresponding to 75.0 cases per 100,000 (95% confidence interval [CI]: 63.3-86.3) for all ages and 335.3 (95% CI: 293.2-377.5) in patients aged >= 65 years. We estimate 3.8 influenza-associated excess C&R hospitalizations for each hospitalization coded with an influenza-specific diagnosis in patients aged >= 65 years. The mean direct annual cost of the estimated excess C&R hospitalizations was (sic)142.9 million for all ages and (sic)115.9 million for patients aged >= 65 years. Mean annual influenza-associated all-cause mortality per 100,000 people was estimated at 27.7 for all ages. Conclusions Results suggest a relevant under-detected burden of influenza mostly in the elderly population, but not neglectable in younger people.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/15264
url https://fisabio.portalinvestigacion.com/publicaciones/15264
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv BMC INFECTIOUS DISEASES
ISSN: 14712334
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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