tetano
Editor, Senior Moderator
Open Forum Infect Dis. 2019 Feb 15;6(3)
fz053. doi: 10.1093/ofid/ofz053. eCollection 2019 Mar.
[h=1]Comparative Outcomes of Adults Hospitalized With Seasonal Influenza A or B Virus Infection: Application of the 7-Category Ordinal Scale.[/h] Wang Y[SUP]1,[/SUP][SUP]2[/SUP], Fan G[SUP]3,[/SUP][SUP]2[/SUP], Horby P[SUP]4[/SUP], Hayden F[SUP]5[/SUP], Li Q[SUP]6[/SUP], Wu Q[SUP]1[/SUP], Zou X[SUP]1[/SUP], Li H[SUP]1[/SUP], Zhan Q[SUP]1[/SUP], Wang C[SUP]1,[/SUP][SUP]2,[/SUP][SUP]7[/SUP], Cao B[SUP]1,[/SUP][SUP]2,[/SUP][SUP]7[/SUP]; CAP-China Network.
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] The objective of this study was to investigate the difference in disease severity between influenza A and B among hospitalized adults using a novel ordinal scale and existing clinical outcome end points.
[h=4]Methods:[/h] A prospective, observational study was conducted over the 2016-2018 influenza seasons in a central hospital. The primary outcome was the rate of clinical improvement, defined as a decline of 2 categories from admission on a 7-category ordinal scale that ranges from 1 (discharged with normal activity) to 7 (death), or hospital discharge up to day 28.
[h=4]Results:[/h] In total, 574 eligible patients were enrolled, including 369 (64.3%) influenza A cases and 205 (35.7%) influenza B cases. The proportion of patients with a worse ordinal scale at admission was higher in influenza A than influenza B (P = .0005). Clinical improvement up to 28 days occurred in 82.4% of patients with influenza A and 90.7% of patients with influenza B (P = .0067). The Cox model indicated that influenza B patients had a higher clinical improvement probability than influenza A cases (adjusted hazard ratio
, 1.266; 95% confidence interval [CI], 1.019-1.573; P = .0335). A similar pattern was observed in weaning oxygen supplement (adjusted HR, 1.285; 95% CI, 1.030-1.603; P = .0261). In-hospital mortality for influenza A was marginally higher than influenza B (11.4% vs 6.8%; P = .0782).
[h=4]Conclusions:[/h] Our findings indicated that hospitalized patients with influenza A were more ill and had delayed clinical improvement compared with those with influenza B virus infection.
[h=4]KEYWORDS:[/h] clinical outcomes; hospitalization; influenza B virus; influenza infection; mortality
PMID: 30895200 PMCID: PMC6419989 DOI: 10.1093/ofid/ofz053
fz053. doi: 10.1093/ofid/ofz053. eCollection 2019 Mar.[h=1]Comparative Outcomes of Adults Hospitalized With Seasonal Influenza A or B Virus Infection: Application of the 7-Category Ordinal Scale.[/h] Wang Y[SUP]1,[/SUP][SUP]2[/SUP], Fan G[SUP]3,[/SUP][SUP]2[/SUP], Horby P[SUP]4[/SUP], Hayden F[SUP]5[/SUP], Li Q[SUP]6[/SUP], Wu Q[SUP]1[/SUP], Zou X[SUP]1[/SUP], Li H[SUP]1[/SUP], Zhan Q[SUP]1[/SUP], Wang C[SUP]1,[/SUP][SUP]2,[/SUP][SUP]7[/SUP], Cao B[SUP]1,[/SUP][SUP]2,[/SUP][SUP]7[/SUP]; CAP-China Network.
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] The objective of this study was to investigate the difference in disease severity between influenza A and B among hospitalized adults using a novel ordinal scale and existing clinical outcome end points.
[h=4]Methods:[/h] A prospective, observational study was conducted over the 2016-2018 influenza seasons in a central hospital. The primary outcome was the rate of clinical improvement, defined as a decline of 2 categories from admission on a 7-category ordinal scale that ranges from 1 (discharged with normal activity) to 7 (death), or hospital discharge up to day 28.
[h=4]Results:[/h] In total, 574 eligible patients were enrolled, including 369 (64.3%) influenza A cases and 205 (35.7%) influenza B cases. The proportion of patients with a worse ordinal scale at admission was higher in influenza A than influenza B (P = .0005). Clinical improvement up to 28 days occurred in 82.4% of patients with influenza A and 90.7% of patients with influenza B (P = .0067). The Cox model indicated that influenza B patients had a higher clinical improvement probability than influenza A cases (adjusted hazard ratio
, 1.266; 95% confidence interval [CI], 1.019-1.573; P = .0335). A similar pattern was observed in weaning oxygen supplement (adjusted HR, 1.285; 95% CI, 1.030-1.603; P = .0261). In-hospital mortality for influenza A was marginally higher than influenza B (11.4% vs 6.8%; P = .0782).
[h=4]Conclusions:[/h] Our findings indicated that hospitalized patients with influenza A were more ill and had delayed clinical improvement compared with those with influenza B virus infection.
[h=4]KEYWORDS:[/h] clinical outcomes; hospitalization; influenza B virus; influenza infection; mortality
PMID: 30895200 PMCID: PMC6419989 DOI: 10.1093/ofid/ofz053