scholarly journals Risk factors for hospital-acquired influenza A and patient characteristics: a matched case-control study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kui Yang ◽  
Ni Zhang ◽  
Chunchen Gao ◽  
Hongyan Qin ◽  
Anhui Wang ◽  
...  

Abstract Background While hospital-acquired influenza A results in an additional cost burden and considerable mortality in patients, its risk factors are unknown. We aimed to describe the characteristics of patients vulnerable to hospital-acquired influenza A and to identify its risk factors to assist clinicians control hospital-acquired infections and reduce the burden of treatment. Methods A case-control study was conducted among hospitalized patients aged ≥18 years at a tertiary level teaching hospital during the 2018–2019 influenza A season. Patient data were retrieved from hospital-based electronic medical records. Hospital-acquired influenza A was defined as a case of influenza A diagnosed 7 days or more after admission, in a patient with no evidence of influenza A infection on admission. The controls without influenza A were selected among patients exposed to the same setting and time period. We identified risk factors using conditional logistic regression and described the characteristics of hospital-acquired influenza A by comparing the clinical data of infected patients and the controls. Results Of the 412 hospitalized patients with influenza A from all the departments in the study hospital, 93 (22.6%) cases were classified as hospital-acquired. The most common comorbidities of the 93 cases were hypertension (41.9%), coronary heart disease (21.5%), and cerebrovascular disease (20.4%). Before the onset of hospital-acquired influenza A, patients presented more lymphocytopenia (51.6% vs 35.5%, P = 0.027), hypoalbuminemia (78.5% vs 57.0%, P = 0.002), and pleural effusion (26.9% vs 9.7%, P = 0.002) than the matched controls. Infected patients also had longer hospital stays (18 days vs 14 days, P = 0.002), and higher mortality rates (10.8% vs 2.2%, P = 0.017) than the matched controls. Lymphocytopenia (odds ratio [OR]: 3.11; 95% confidence interval [CI]: 1.24–7.80; P = 0.016), hypoalbuminemia (OR: 2.24; 95% CI: 1.10–4.57; P = 0.027), and pleural effusion (OR: 3.09; 95% CI: 1.26–7.58; P = 0.014) were independently associated with hospital-acquired influenza A. Conclusions Lymphocytopenia, hypoalbuminemia and pleural effusion are independent risk factors that can help identify patients at high risk of hospital-acquired influenza A, which can extend hospital stay and is associated with a high mortality.

2020 ◽  
Author(s):  
Kui Yang ◽  
Ni Zhang ◽  
Chunchen Gao ◽  
Hongyan Qin ◽  
Anhui Wang ◽  
...  

Abstract Background: While hospital-acquired influenza A results in an additional cost burden and considerable mortality in patients, its risk factors are unknown. We aimed to describe the characteristics of patients vulnerable to hospital-acquired influenza A and to identify its risk factors to assist clinicians control hospital-acquired infections and reduce the burden of treatment.Methods: A case-control study was conducted among hospitalized patients aged ≥18 years at a tertiary level teaching hospital during the 2018–2019 influenza A season. Patient data were retrieved from hospital-based electronic medical records. Hospital-acquired influenza A was defined as a case of influenza A diagnosed 7 days or more after admission, in a patient with no evidence of influenza A infection on admission. The controls without influenza A were selected among patients exposed to the same setting and time period. We identified risk factors using conditional logistic regression and described the characteristics of hospital-acquired influenza A by comparing the clinical data of infected patients and the controls.Results: Of the 412 hospitalized patients with influenza A from all the departments in the study hospital, 93 (22.6%) cases were classified as hospital-acquired. The most common comorbidities of the 93 cases were hypertension (41.9%), coronary heart disease (21.5%), and cerebrovascular disease (20.4%). Before the onset of hospital-acquired influenza A, patients presented more lymphocytopenia (51.6% vs 35.5%, P=0.027), hypoalbuminemia (78.5% vs 57.0%, P=0.002), and pleural effusion (26.9% vs 9.7%, P=0.002) than the matched controls. Infected patients also had longer hospital stays (18 days vs 14 days, P=0.002), and higher mortality rates (10.8% vs 2.2%, P=0.017) than the matched controls. Lymphocytopenia (odds ratio [OR]: 3.11; 95% confidence interval [CI]: 1.24–7.80; P=0.016), hypoalbuminemia (OR: 2.24; 95% CI: 1.10–4.57; P=0.027), and pleural effusion (OR: 3.09; 95% CI: 1.26–7.58; P=0.014) were independently associated with hospital-acquired influenza A.Conclusions: Lymphocytopenia, hypoalbuminemia and pleural effusion are independent risk factors that can help identify patients at high risk of hospital-acquired influenza A, which can extend hospital stay and is associated with a high mortality.


2020 ◽  
Author(s):  
Kui Yang ◽  
Ni Zhang ◽  
Chunchen Gao ◽  
Hongyan Qin ◽  
Anhui Wang ◽  
...  

Abstract Background: While hospital-acquired influenza A results in an additional cost burden and considerable mortality in patients, its risk factors are unknown. We aimed to describe the characteristics of patients vulnerable to hospital-acquired influenza A and to identify its risk factors to assist clinicians control hospital-acquired infections and reduce the burden of treatment.Methods: A case-control study was conducted among hospitalized patients aged ≥18 years at a tertiary level teaching hospital during the 2018–2019 influenza A season. Patient data were retrieved from hospital-based electronic medical records. Hospital-acquired influenza A was defined as a case of influenza A diagnosed 7 days or more after admission, in a patient with no evidence of influenza A infection on admission. The controls without influenza A were selected among patients exposed to the same setting and time period. We identified risk factors using conditional logistic regression and described the characteristics of hospital-acquired influenza A by comparing the clinical data of infected patients and the controls.Results: Of the 412 hospitalized patients with influenza A from all the departments in the study hospital, 93 (22.6%) cases were classified as hospital-acquired. The most common comorbidities of the 93 cases were hypertension (41.9%), coronary heart disease (21.5%), and cerebrovascular disease (20.4%). Before the onset of hospital-acquired influenza A, patients presented more lymphocytopenia (51.6% vs 35.5%, P=0.027), hypoalbuminemia (78.5% vs 57.0%, P=0.002), and pleural effusion (26.9% vs 9.7%, P=0.002) than the matched controls. Infected patients also had longer hospital stays (18 days vs 14 days, P=0.002), and higher mortality rates (10.8% vs 2.2%, P=0.017) than the matched controls. Lymphocytopenia (odds ratio [OR]: 3.11; 95% confidence interval [CI]: 1.24–7.80; P=0.016), hypoalbuminemia (OR: 2.24; 95% CI: 1.10–4.57; P=0.027), and pleural effusion (OR: 3.09; 95% CI: 1.26–7.58; P=0.014) were independently associated with hospital-acquired influenza A.Conclusions: Lymphocytopenia, hypoalbuminemia and pleural effusion are independent risk factors that can help identify patients at high risk of hospital-acquired influenza A, which can extend hospital stay and is associated with a high mortality.


2020 ◽  
Author(s):  
Kui Yang ◽  
Ni Zhang ◽  
Chunchen Gao ◽  
Hongyan Qin ◽  
Anhui Wang ◽  
...  

Abstract Background: Hospital-acquired influenza A brings hospitalized patients an additional cost of care and considerable mortality, but risk factors for hospital-acquired influenza A are unknown. We aimed to describe the characteristics of patients vulnerable for hospital-acquired influenza A and to identify its risk factors. This knowledge would help clinicians to control hospital-acquired infection and reduce the burden of treatment.Methods: A case-control study was conducted in hospitalized patients aged ≥18 years in a tertiary level teaching hospital during the 2018–2019 influenza A season. Patient data were retrieved from hospital-based electronic medical records. Hospital-acquired influenza A was defined as a case of influenza A diagnosed 7 days or more after admission, in a patient who had no evidence of viral respiratory infection on admission. The controls without influenza were selected among patients exposed to the same setting during the same time period. We identified risk factors using conditional logistic regression and described characteristics of patients with hospital-acquired influenza A by comparing the clinical data of the influenza patients and the controls.Results: Of 412 hospitalized patients with influenza A from all departments of the study hospital, 93 (22.6%) cases were classified as hospital-acquired. The most common comorbidities of the 93 cases were hypertension (41.9%), coronary heart disease (21.5%) and cerebrovascular disease (20.4%). Before the onset of hospital-acquired influenza A, patients presented more lymphocytopenia (51.6% vs 35.5%, P=0.027), hypoalbuminemia (78.5% vs 57.0%, P=0.002) and pleural effusion (26.9% vs 9.7%, P=0.002) than matched controls. Notably, infected patients had a longer hospital stay (18 days vs 14 days, P=0.002), and higher mortality (10.8% vs 2.2%, P=0.017). Lymphocytopenia (odds ratio [OR]: 3.11; 95% confidence interval [CI]: 1.24–7.80; P =0.016), hypoalbuminemia (OR: 2.24; 95% CI: 1.10–4.57; P =0.027) and pleural effusion (OR: 3.09; 95% CI: 1.26–7.58; P =0.014) were independently associated with hospital-acquired influenza A.Conclusions: Lymphocytopenia, hypoalbuminemia and pleural effusion were independent risk factors that could help identify patients at high risk of hospital-acquired influenza A, which might extend hospital stay and is associated with a high mortality.


2020 ◽  
Author(s):  
Kui Yang ◽  
Ni Zhang ◽  
Chunchen Gao ◽  
Hongyan Qin ◽  
Anhui Wang ◽  
...  

Abstract Background: Nosocomial influenza A brings hospitalized patients additional cost of care and considerable mortality, but predictors for hospital-acquired influenza A at the early stage remained unidentified. We aimed to describe the characteristics of patients vulnerable for hospital-acquired influenza A and identify its risk factors, which would help clinicians control nosocomial infection and ease the burden of treatment. Methods: A case-control study was conducted in hospitalized patients aged ≥ 18 years in a level A tertiary teaching hospital during the 2018-2019 influenza A season. Information of patients was retrieved from hospital-based medical records system. Hospital-acquired influenza A was defined as cases diagnosed 7 days or more after admission, who had no signs of viral respiratory infection on admission. The controls with no influenza infection were selected by the following criterion. Namely, patients were exposed to the same setting in the same period of time. We identified risk factors using conditional logistic regression and described characteristics of hospital-acquired influenza A through comparing the clinical data between influenza infected patients and controls. Results: Of 412 hospitalized patients with influenza A from all departments of the investigated hospital, 93 (22.6%) cases were classified as hospital-acquired influenza A. Older age (>65 years old) accounted for 34.4%. Hypertension (41.9%), coronary heart disease (21.5%) and cerebrovascular disease (20.4%) were the most common comorbidities. Before the infection of hospital-acquired influenza A, patients presented more lymphocytopenia (51.6% VS 35.5%, P=0.027), hypoalbuminemia (78.5% VS 57.0%, P=0.002) and pleural effusion (26.9% VS 9.7%, P=0.002) than matched controls. Notably, infected patients had a longer hospital stay [18(12-27.5) days VS 14(11-20) days, P=0.002], and higher mortality (10.8% VS 2.2%, P=0.017 ). Lymphocytopenia (OR: 3.107; 95% CI 1.238-7.796; P =0.016), hypoalbuminemia (OR: 2.241; 95% CI 1.099-4.570; P =0.027) and pleural effusion (OR: 3.094; 95% CI 1.263-7.583; P =0.014) were independently associated with hospital-acquired influenza A. Conclusions: Lymphocytopenia, hypoalbuminemia and pleural effusion were independent risk factors that could help identify patients at high risk of hospital-acquired influenza A, which extended hospital stay and was associated with high mortality.


1997 ◽  
Vol 119 (3) ◽  
pp. 307-311 ◽  
Author(s):  
K. R. NEAL ◽  
R. C. B. SLACK

The epidemiology of notified cases of campylobacter gastroenteritis in adults in Nottingham Health District was investigated using a case-control study with a postal questionnaire to ascertain data on risk factors. Over a 14-month period 531 cases (a 73% response rate of all laboratory confirmed cases) and 512 controls replied.Conditional logistic regression analysis was used to determine independent associations with infection. These included foreign travel (odds ratio (OR) 3·4; 95% confidence intervals (CI) 2·0–5·7), diabetes mellitus (OR 4·1, CI 1·1–17), medication with omeprazole (OR 3·5, CI 1·1–12) and H2 and H2 antagonists (OR 3·7, CI 1·3–15), contact with puppies (OR11·3, CI1·2–105), eating chicken (OR 1·4, CI 1·1–1·8) and drinking milk from bottles with tops damaged by a bird (OR 3·3, CI 1·0–11). Preparing main meals (OR 0·9, CI 0·8–1·0) and drinking delivered milk (OR 0·6, CI 0·4–0·9) were associated with a reduced risk of campylobacter infection.Foreign travel was reported in 25% of cases and another 15% had significant associations with other risk factors. The majority of cases, 60%, remained unexplained, indicating the need for further evolution of sporadic cases.


2021 ◽  
pp. 1-8
Author(s):  
Viggo Holten Mortensen ◽  
Mette Søgaard ◽  
Brian Kristensen ◽  
Lone Hagens Mygind ◽  
Henrik Carl Schønheyder

2009 ◽  
Vol 67 (2a) ◽  
pp. 229-234 ◽  
Author(s):  
Kátia Regina Penha da Silva ◽  
Regina Maria Papais Alvarenga ◽  
Oscar Fernandez y Fernandez ◽  
Hélcio Alvarenga ◽  
Luiz Claudio Santos Thuler

PURPOSE: To evaluate potential risk factors for the development of multiple sclerosis in Brazilian patients. METHOD: A case control study was carried out in 81 patients enrolled at the Department of Neurology of the Hospital da Lagoa in Rio de Janeiro, and 81 paired controls. A standardized questionnaire on demographic, social and cultural variables, and medical and family history was used. Statistical analysis was performed using descriptive statistics and conditional logistic regression models with the SPSS for Windows software program. RESULTS: Having standard vaccinations (vaccinations specified by the Brazilian government) (OR=16.2; 95% CI=2.3-115.2), smoking (OR=7.6; 95% CI=2.1-28.2), being single (OR=4.7; 95% CI=1.4-15.6) and eating animal brain (OR=3.4; 95% CI=1.2-9.8) increased the risk of developing MS. CONCLUSIONS: RESULTS of this study may contribute towards better awareness of the epidemiological characteristics of Brazilian patients with multiple sclerosis.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Hanh Thi Duc Tran ◽  
Jan Hattendorf ◽  
Hung Manh Do ◽  
Thanh Tien Hoang ◽  
Hang Thi Hai Hoang ◽  
...  

Abstract Background The risk factors for scrub typhus in Vietnam remain unknown. Scrub typhus caused by Orientia tsutsugamushi often presents as an undifferentiated febrile illness and remains under appreciated due to the limited availability of diagnostic tests. This tropical rickettsial illness is increasingly recognized as an important cause of non-malaria acute undifferentiated fever in Asia. This study aimed to investigate behavioural and ecological related risk factors of scrub typhus to prevent this potentially life-threatening disease in Vietnam. Methods We conducted a clinical hospital-based active surveillance study, and a retrospective residence-enrolment date-age-matched case–control study in Khanh Hoa province, Vietnam, from August 2018 to March 2020. Clinical examinations, polymerase chain reaction and enzyme-linked immunosorbent assay IgM tests were applied to define cases and controls. All enrolled participants filled out a questionnaire including demographic socio-economic status, personal behaviors/protective equipment, habitat connections, land use, and possible exposure to the vector. Multivariable conditional logistic regression was used to define the scrub typhus associated risk factors. Results We identified 44 confirmed cases and matched them with 152 controls. Among cases and controls, the largest age group was the 41–50 years old and males accounted for 61.4% and 42.8%, respectively. There were similarities in demographic characteristics between the two groups, with the exception of occupation. Several factors were significantly associated with acquisition of scrub typhus, including sitting/laying directly on household floor [adjusted OR (aOR) = 4.9, 95% CI: 1.6–15.1, P = 0.006], household with poor sanitation/conditions (aOR = 7.9, 95% CI: 1.9–32.9, P = 0.005), workplace environment with risk (aOR = 3.0, 95% CI: 1.2–7.6, P = 0.020), always observing mice around home (aOR = 3.7, 95% CI: 1.4–9.9, P = 0.008), and use of personal protective equipment in the field (aOR = 0.4, 95% CI: 0.1–1.1, P = 0.076). Conclusions Ecological and household hygiene-related factors were more associated with scrub typhus infection, than individual-level exposure activities in the hyper-endemic area. These findings support local education and allow people to protect themselves from scrub typhus, especially in areas with limitations in diagnostic capacity. Graphical abstract


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