tetano
Editor, Senior Moderator
J Am Med Dir Assoc. 2019 Aug 21. pii: S1525-8610(19)30520-1. doi: 10.1016/j.jamda.2019.06.025. [Epub ahead of print]
[h=1]Hospital Influenza Admissions as a Harbinger for Nursing Home Influenza Cases.[/h] McConeghy KW[SUP]1[/SUP], Huang SS[SUP]2[/SUP], Miller LG[SUP]3[/SUP], McKinnell JA[SUP]3[/SUP], Shireman TI[SUP]4[/SUP], Mor V[SUP]4[/SUP], Gravenstein S[SUP]5[/SUP].
[h=3]Author information[/h] 1 Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI; Center of Innovation-Long-Term Services and Supports, Providence VA Medical Center, Providence, RI. Electronic address: kevin_mcconeghy@brown.edu. 2 Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, CA. 3 Infectious Disease Clinical Outcomes Research Unit (ID-CORE), Division of Infectious Disease, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA. 4 Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI; Center of Innovation-Long-Term Services and Supports, Providence VA Medical Center, Providence, RI. 5 Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI; Center of Innovation-Long-Term Services and Supports, Providence VA Medical Center, Providence, RI; Department of Medicine, Warren-Alpert School of Medicine, Brown University, Providence, RI.
[h=3]Abstract[/h] [h=4]OBJECTIVES:[/h] To determine temporal associations of local measures of influenza morbidity and mortality by the Centers for Disease Control and Prevention (CDC) with influenza hospitalizations in nursing home residents.
[h=4]DESIGN:[/h] Retrospective, longitudinal panel study.
[h=4]SETTING AND PARTICIPANTS:[/h] Long-stay nursing home residents, aged 65 years or older in 823 nursing homes from 2011 to 2015.
[h=4]MEASURES:[/h] CDC-reported rates of influenza and pneumonia mortality and laboratory-confirmed influenza hospitalizations. We compared the CDC measures to nursing home resident hospitalizations due to (1) all-cause, (2) a primary diagnosis of respiratory or circulatory illness, and (3) a primary diagnosis of pneumonia or influenza based on Medicare Part A Claims data.
[h=4]RESULTS:[/h] Our final sample included 273,743 unique residents in 819 nursing homes in 108 cities. National laboratory-confirmed influenza-associated hospitalizations for the group aged 65 and older occurred 0 to 1 week prior to nursing home resident influenza-related hospitalizations (Spearman ρ = 0.54). CDC-reported influenza hospitalizations occurred 3 weeks prior to CDC-reported influenza deaths (ρ = 0.59). Nursing home resident influenza hospitalizations occurred 2 weeks before local CDC-reported pneumonia and influenza deaths occurred (ρ = 0.44).
[h=4]CONCLUSIONS/IMPLICATIONS:[/h] Publicly reported CDC measures correlate well with nursing home hospitalizations for pneumonia and influenza. Rates of laboratory-confirmed influenza hospitalizations (as reported by the CDC) may be a useful surrogate for nursing home influenza outbreaks but should be considered along with local indicators of disease outbreaks. Early community signals could be clinically leveraged as a trigger for increased infection control measures in nursing homes.
Published by Elsevier Inc.
[h=4]KEYWORDS:[/h] Human influenza; hospitalization; nursing homes
PMID: 31445924 DOI: 10.1016/j.jamda.2019.06.025
[h=1]Hospital Influenza Admissions as a Harbinger for Nursing Home Influenza Cases.[/h] McConeghy KW[SUP]1[/SUP], Huang SS[SUP]2[/SUP], Miller LG[SUP]3[/SUP], McKinnell JA[SUP]3[/SUP], Shireman TI[SUP]4[/SUP], Mor V[SUP]4[/SUP], Gravenstein S[SUP]5[/SUP].
[h=3]Author information[/h] 1 Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI; Center of Innovation-Long-Term Services and Supports, Providence VA Medical Center, Providence, RI. Electronic address: kevin_mcconeghy@brown.edu. 2 Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, CA. 3 Infectious Disease Clinical Outcomes Research Unit (ID-CORE), Division of Infectious Disease, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA. 4 Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI; Center of Innovation-Long-Term Services and Supports, Providence VA Medical Center, Providence, RI. 5 Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI; Center of Innovation-Long-Term Services and Supports, Providence VA Medical Center, Providence, RI; Department of Medicine, Warren-Alpert School of Medicine, Brown University, Providence, RI.
[h=3]Abstract[/h] [h=4]OBJECTIVES:[/h] To determine temporal associations of local measures of influenza morbidity and mortality by the Centers for Disease Control and Prevention (CDC) with influenza hospitalizations in nursing home residents.
[h=4]DESIGN:[/h] Retrospective, longitudinal panel study.
[h=4]SETTING AND PARTICIPANTS:[/h] Long-stay nursing home residents, aged 65 years or older in 823 nursing homes from 2011 to 2015.
[h=4]MEASURES:[/h] CDC-reported rates of influenza and pneumonia mortality and laboratory-confirmed influenza hospitalizations. We compared the CDC measures to nursing home resident hospitalizations due to (1) all-cause, (2) a primary diagnosis of respiratory or circulatory illness, and (3) a primary diagnosis of pneumonia or influenza based on Medicare Part A Claims data.
[h=4]RESULTS:[/h] Our final sample included 273,743 unique residents in 819 nursing homes in 108 cities. National laboratory-confirmed influenza-associated hospitalizations for the group aged 65 and older occurred 0 to 1 week prior to nursing home resident influenza-related hospitalizations (Spearman ρ = 0.54). CDC-reported influenza hospitalizations occurred 3 weeks prior to CDC-reported influenza deaths (ρ = 0.59). Nursing home resident influenza hospitalizations occurred 2 weeks before local CDC-reported pneumonia and influenza deaths occurred (ρ = 0.44).
[h=4]CONCLUSIONS/IMPLICATIONS:[/h] Publicly reported CDC measures correlate well with nursing home hospitalizations for pneumonia and influenza. Rates of laboratory-confirmed influenza hospitalizations (as reported by the CDC) may be a useful surrogate for nursing home influenza outbreaks but should be considered along with local indicators of disease outbreaks. Early community signals could be clinically leveraged as a trigger for increased infection control measures in nursing homes.
Published by Elsevier Inc.
[h=4]KEYWORDS:[/h] Human influenza; hospitalization; nursing homes
PMID: 31445924 DOI: 10.1016/j.jamda.2019.06.025