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Impact of prompt influenza antiviral treatment on extended care needs after influenza hospitalization among community-dwelling older adults.
Clin Infect Dis. 2015 Sep 2;
Authors: Chaves SS, Pérez A, Miller L, Bennett NM, Bandyopadhyay A, Farley MM, Fowler B, Hancock EB, Kirley PD, Lynfield R, Ryan P, Morin C, Schaffner W, Sharangpani R, Lindegren ML, Tengelsen L, Thomas A, Hill MB, Bradley KK, Oni O, Meek J, Zansky S, Widdowson MA, Finelli L
Abstract
BACKGROUND: Patients hospitalized with influenza may require extended care upon discharge. We aimed to explore predictors for extended care needs and the potential mitigating effect of antiviral treatment among community-dwelling adults aged ≥65 years hospitalized with influenza.
METHODS: We used laboratory-confirmed influenza hospitalizations from 3 influenza seasons. Extended care was defined as new placement in a skilled nursing home/long-term/rehabilitation facility upon hospital discharge. We focused on those treated with antiviral agents to explore the effect of early treatment on extended care and hospital length of stay (LOS) using logistic regression and competing risk survival analysis, accounting for time from illness onset to hospitalization. Treatment was categorized as early (≤4 days) and late (>4 days) in reference to date of illness onset.
RESULTS: Among 6,593 community-dwelling adults aged ≥65 years hospitalized for influenza, 18% required extended care at discharge. Need for care increased with age and neurologic disorders, ICU admission, and pneumonia were predictors of care needs. Early treatment reduced the odds of extended care after hospital discharge for those hospitalized ≤2 or >2 days from illness onset (adjusted odds ratio [aOR] 0.38; 95% confidence interval [CI] 0.17, 0.85, and aOR 0.75; 95% CI 0.56, 0.97 respectively). Early treatment was also independently associated with reduction in LOS for those hospitalized ≤2 days from illness onset (adjusted hazard ratio [aHR] 1.81; 95% CI 1.43, 2.30) or >2 days (aHR 1.30; 95% CI 1.20, 1.40).
CONCLUSIONS: Prompt antiviral treatment decreases the impact of influenza on older adults through shorten hospitalization and reduced extended care needs.
PMID: 26334053 [PubMed - as supplied by publisher]