Impact of prompt influenza antiviral treatment on extended care needs after influenza hospitalization among community-dwelling older adults

Sandra S Chaves, Alejandro Pérez, Lisa Miller, Nancy M Bennett, Ananda Bandyopadhyay, Monica M Farley, Brian Fowler, Emily B Hancock, Pam Daily Kirley, Ruth Lynfield, Patricia Ryan, Craig Morin, William Schaffner, Ruta Sharangpani, Mary Lou Lindegren, Leslie Tengelsen, Ann Thomas, Mary B Hill, Kristy K Bradley, Oluwakemi OniJames Meek, Shelley Zansky, Marc-Alain Widdowson, Lyn Finelli

Research output: Contribution to journalA1: Web of Science-article

Abstract

BACKGROUND: Patients hospitalized with influenza may require extended care on 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 on 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 using logistic regression and competing risk survival analysis, accounting for time from illness onset to hospitalization. Treatment was categorized as early (≤ 4 days) or late (>4 days) in reference to date of illness onset.

RESULTS: Among 6593 community-dwelling adults aged ≥ 65 years hospitalized for influenza, 18% required extended care at discharge. The need for care increased with age and neurologic disorders, intensive care unit 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, 0.38 [95% confidence interval {CI}, .17-.85] and 0.75 [.56-.97], respectively). Early treatment was also independently associated with reduction in length of stay for those hospitalized ≤ 2 days from illness onset (adjusted hazard ratio, 1.81; 95% CI, 1.43-2.30) or >2 days (1.30; 1.20-1.40).

CONCLUSIONS: Prompt antiviral treatment decreases the impact of influenza on older adults through shorten hospitalization and reduced extended care needs.

Original languageEnglish
JournalClinical Infectious Diseases
Volume61
Issue number12
Pages (from-to)1807-14
Number of pages8
ISSN1058-4838
DOIs
Publication statusPublished - 2015

Keywords

  • Aged
  • Aged, 80 and over
  • Antiviral Agents/administration & dosage
  • Female
  • Hospitalization
  • Humans
  • Influenza, Human/diagnosis
  • Length of Stay
  • Male
  • Secondary Prevention
  • Skilled Nursing Facilities/statistics & numerical data
  • Treatment Outcome

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