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- Title
Impact of Prompt Influenza Antiviral Treatment on Extended Care Needs After Influenza Hospitalization Among Community-Dwelling Older Adults.
- Authors
Chaves, Sandra S.; Pérez, Alejandro; Miller, Lisa; Bennett, Nancy M.; Bandyopadhyay, Ananda; Farley, Monica M.; Fowler, Brian; Hancock, Emily B.; Kirley, Pam Daily; Lynfield, Ruth; Ryan, Patricia; Morin, Craig; Schaffner, William; Sharangpani, Ruta; Lindegren, Mary Lou; Tengelsen, Leslie; Thomas, Ann; Hill, Mary B.; Bradley, Kristy K.; Oni, Oluwakemi
- 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 communitydwelling 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.
- Subjects
INFLUENZA treatment; ANTIVIRAL agents; HOSPITAL care of older people; HOSPITAL admission &; discharge; EXTENDED care units in hospitals
- Publication
Clinical Infectious Diseases, 2015, Vol 61, Issue 12, p1807
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/civ733