Age, Sex, Kidney Disease Predict Mortality for Patients Hospitalized With Respiratory Diseases

Older age, male gender, long-term care residence, and chronic kidney disease have been found to be common predictors of increased mortality in patients hospitalized for influenza. Respiratory According to recent reports, Synthetic Virus (RSV), or SARS-CoV-2 Research published in Influenza and other respiratory viruses..

Researchers have also found associations between mortality and comorbidity, immunity to influenza, and geographic location, but these associations vary in intensity depending on the disease.

“Knowing who has the highest risk of serious respiratory illness is to support aggressive clinical decision-making and distribute resources to medical settings with a high prevalence of risk factors. It can be useful, “the author writes. “This is especially useful in situations of newly emerging respiratory viruses that lack information and resources.”

Researchers conducted a retrospective cohort study to identify predictors of all-cause mortality for 30 days after hospitalization for influenza, RSV, or SARS-CoV-2. Population-based laboratory and management data was collected from Ontario, Canada.

Researchers evaluated the association between potential predictors and mortality by comparing risk ratio directions, magnitudes, and CIs among the three study cohorts.

They observed a total of 45,749 influenza hospitalizations, 24,345 RSV hospitalizations, and 8988 SARS-CoV-2 hospitalizations after applying both inclusion and exclusion criteria.

Patients with RSV were generally younger and had fewer comorbidities than patients in other cohorts.

The study found that 3186 influenza patients, 697 RSV patients, and 1880 SARS-CoV-2 patients died within 30 days of admission. Patients hospitalized for SARS-CoV-2 had the highest all-cause mortality rate for 30 days at 20.9%, followed by influenza (7.0%) and RSV (2.9%).

Older age, male gender, long-term care residence, and chronic kidney disease have been found to be common predictors of increased mortality.

The positive association between age and mortality is highest in patients with SARS-CoV-2, supporting previous studies. However, there were few comorbidities associated with mortality in patients with SARS-CoV-2 compared to patients with influenza or RSV.

The authors need further research to compare the immunological and clinical disease progression of influenza, RSV, and SARS-CoV-2 to better explain the observed differences in risk from comorbidities. It suggests that.

Rural residence was found to be associated with a 30-day increase in all-cause mortality in patients with RSV and SARS-CoV-2 (RSV: adjusted relative risk). [RR], 1.52; 95% CI, 1.09-2.12; SARS-CoV-2: Adjusted RR, 1.27; 95% CI, 1.01-1.61). Immunization to seasonal influenza was found to be associated with a 30-day reduction in all-cause mortality in influenza patients (adjusted RR, 0.89; 95% CI, 0.83-0.96).

For patients with influenza and RSV, cardiac ischemic disease, congestive heart failure, dementia / weakness, and immunosuppression were all associated with increased mortality from all causes.

No association between community-level social determinants of health and all-cause mortality during the 30 days after admission was observed in any cohort, despite the association with infection risk.

According to the author, these results have three important implications for clinical and healthcare systems.

• Mortality shared predictors can be used to identify, target, and prioritize inpatients at highest risk of death for prevention, testing, and treatment in the context of new respiratory pathogens. ..
• The underlying prevalence of shared predictors in a particular region can help prepare the medical system and efficiently allocate resources in the event of the emergence of new respiratory pathogens.
• The differences in predictors of mortality observed among the three viruses indicate the importance of adequate virus-specific laboratory tests to identify individuals at risk.

Therefore, the authors identify patients at highest risk of illness, anticipate hospital resource needs, and prioritize community prevention and treatment strategies to communities with high risk factor prevalence. I hope it helps.

There was a limit to this research.The data may have captured deaths (ie, deaths) in the context of viral deaths or accidental infections. When virus). The authors estimated that approximately 3% of deaths resulting from SARS-CoV-2 in their study could be due to viral deaths.

In addition, the end of the study period of December 1, 2020 excluded patients who were vaccinated with SARS-CoV-2 or patients with SARS-CoV-2 variants.

The authors also suggest a lack of data on other predictors and encourage future research.

reference

Predictor of all-cause mortality in patients admitted with Hamilton MA, Liu Y, Calzabara A, Sundalum ME, Jebri M, Durbin D, other influenza, respiratory syncytial virus, or SARS-CoV-2. Influenza and other respiratory viruses. Published online May 24, 2022. doi: 10.1111 / irv.13004