scholarly journals Burden of influenza hospitalization among high-risk groups in the United States

2021 ◽  
Author(s):  
Aimee Near ◽  
Jenny Tse ◽  
Yinong Young-Xu ◽  
David K. Hong ◽  
Carolina M. Reyes
Keyword(s):  
United States ◽  
High Risk ◽  
Risk Groups ◽  
The Elderly ◽  
The United States ◽  
Emergency Department Visits ◽  
Chronic Obstructive ◽  
Elderly Age ◽  
Multivariable Logistic Regression Model ◽  
Stage 1

AbstractBackgroundSeasonal influenza poses a substantial clinical and economic burden in the United States and vulnerable populations, including the elderly and those with comorbidities, are at elevated risk for influenza-related medical complications.MethodsWe conducted a retrospective cohort study using the IQVIA PharMetrics® Plus claims database in two stages. In Stage 1, we identified patients with evidence of medically-attended influenza during influenza seasons from October 1, 2014 to May 31, 2018 (latest available data for Stage 1) and used a multivariable logistic regression model to identify patient characteristics that predicted 30-day influenza-related hospitalization. Findings from Stage 1 informed high-risk subgroups of interest for Stage 2, where we selected cohorts of influenza patients during influenza seasons from October 1, 2014 to March 1, 2019 and used 1:1 propensity score matching to patient without influenza with similar high-risk characteristics to compare influenza-attributable rates of all-cause hospital and emergency department visits during follow-up (30-day and in index influenza season).ResultsIn Stage 1, more than 1.6 million influenza cases were identified, of which 18,509 (1.2%) had a hospitalization. Elderly age was associated with 9 times the odds of hospitalization (≥65 years vs. 5-17 years; OR=9.4, 95% CI 8.8-10.1) and select comorbidities were associated with 2-3 times the odds of hospitalization. In Stage 2, elderly influenza patients with comorbidities had 3 to 7 times higher 30-day hospitalization rates compared to matched patients without influenza, including patients with congestive heart failure (41.0% vs.7.9%), chronic obstructive pulmonary disease (34.6% vs. 6.1%), coronary artery disease (22.8% vs. 3.8%), and late-stage chronic kidney disease (44.1% vs. 13.1%; all p<0.05).ConclusionsThe risk of influenza-related complications is elevated in the elderly, especially those with certain underlying comorbidities, leading to excess healthcare resource utilization. Continued efforts, beyond currently available vaccines, are needed to reduce influenza burden in high-risk populations.

scholarly journals PIN41 INFLUENZA VACCINATION RATES AMONG HIGH RISK GROUPS IN THE UNITED STATES

2011 ◽  
Vol 14 (3) ◽  
pp. A121
Author(s):  
M. DiBonaventura ◽  
J.S. Wagner ◽  
A. Goren
Keyword(s):  
United States ◽  
High Risk ◽  
Influenza Vaccination ◽  
Risk Groups ◽  
The United States ◽  
Vaccination Rates

scholarly journals Prospects for Vaccine Prevention of Meningococcal Infection

2006 ◽  
Vol 19 (1) ◽  
pp. 142-164 ◽  
Author(s):  
Lee H. Harrison
Keyword(s):  
United States ◽  
High Risk ◽  
Bacterial Meningitis ◽  
Neisseria Meningitidis ◽  
Meningococcal Disease ◽  
Risk Groups ◽  
The United States ◽  
Meningococcal Infection ◽  
Meningococcal Vaccine ◽  
The Military

SUMMARY Neisseria meningitidis is the leading cause of bacterial meningitis in the United States and worldwide. A serogroup A/C/W-135/Y polysaccharide meningococcal vaccine has been licensed in the United States since 1981 but has not been used universally outside of the military. On 14 January 2005, a polysaccharide conjugate vaccine that covers meningococcal serogroups A, C, W-135, and Y was licensed in the United States for 11- to 55-year-olds and is now recommended for the routine immunization of adolescents and other high-risk groups. This review covers the changing epidemiology of meningococcal disease in the United States, issues related to vaccine prevention, and recommendations on the use of the new vaccine.

scholarly journals Heterosexual Transmission of Hepatitis B and Implications for Vaccine Prevention Strategies

1991 ◽  
Vol 2 (suppl a) ◽  
pp. 13-17 ◽  
Author(s):  
Miriam J Alter
Keyword(s):  
United States ◽  
Hepatitis B Virus ◽  
High Risk ◽  
Virus Infection ◽  
Hepatitis B ◽  
Risk Groups ◽  
The United States ◽  
Hepatitis B Virus Infection ◽  
B Virus ◽  
Homosexual Activity

Since 1985, cases of hepatitis B virus infection attributable to heterosexual activity have increased by 38%, whereas those attributable to homosexual activity have declined by 62%, Heterosexual activity now accounts for 26% of cases and has replaced homosexual activity in importance as a risk factor for hepatitis B. For heterosexuals, the number of recent (ie, in the preceding four to six months) and lifetime sex partners, as well as a history of other sexually transmitted diseases (eg. syphilis) appear to be significantly associated with increased hepatitis B virus infection. Of equal concern is the rising number of cases among parenteral drug users in the United States and some minority groups, including blacks, Hispanics and Asians. Hepatitis B prevention by administering hepatitis B vaccine to high risk groups before exposure to infection has not been successful, and at least 30% of hepatitis B cases in the United States have no identifiable risk factors. Thus, participation in the current programs which target only high risk groups is not possible. The ideal immunization strategy is integration of hepatitis B vaccine in to the routine childhood immunization schedule.

scholarly journals Why African Americans Are a Potential Target for COVID-19 Infection in the United States

10.2196/19934 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e19934 ◽  
Author(s):  
Alireza Hamidian Jahromi ◽  
Anahid Hamidianjahromi
Keyword(s):  
United States ◽  
Health Care ◽  
Ethnic Minorities ◽  
Risk Groups ◽  
The Elderly ◽  
The United States ◽  
Exponential Phase ◽  
World Health ◽  
Health Organization ◽  
The Impact

Since the World Health Organization declared the coronavirus disease (COVID-19) outbreak a pandemic, significant changes have occurred in the United States as the infection spread reached and passed its exponential phase. A stringent analysis of COVID-19 epidemiologic data requires time and would generally be expected to happen with significant delay after the exponential phase of the disease is over and when the focus of the health care system is diverted away from crisis management. Although much has been said about high-risk groups and the vulnerability of the elderly and patients with underlying comorbidities, the impact of race on the susceptibility of ethnic minorities living in indigent communities has not been discussed in detail worldwide and specifically in the United States. There are currently some data on disparities between African American and Caucasian populations for COVID-19 infection and mortality. While health care authorities are reorganizing resources and infrastructure to provide care for symptomatic COVID-19 patients, they should not shy away from protecting the general public as a whole and specifically the most vulnerable members of society, such as the elderly, ethnic minorities, and people with underlying comorbidities.

scholarly journals Vaccination Rates among the General Adult Population and High-Risk Groups in the United States

PLoS ONE ◽  
2012 ◽  
Vol 7 (11) ◽  
pp. e50553 ◽  
Author(s):  
Kathy Annunziata ◽  
Aaron Rak ◽  
Heather Del Buono ◽  
Marco DiBonaventura ◽  
Girishanthy Krishnarajah
Keyword(s):  
United States ◽  
High Risk ◽  
Adult Population ◽  
Risk Groups ◽  
The United States ◽  
Vaccination Rates ◽  
General Adult Population

scholarly journals Epidemiology and Outcomes of Hospitalizations with Invasive Aspergillosis in the United States, 2010–2013

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S88-S89
Author(s):  
Marya D Zilberberg ◽  
Brian Nathanson ◽  
Rachel Harrington ◽  
James Spalding ◽  
Andrew F Shorr
Keyword(s):  
United States ◽  
Critical Illness ◽  
High Risk ◽  
Invasive Aspergillosis ◽  
The United States ◽  
Major Surgery ◽  
Chronic Obstructive ◽  
Solid Organ ◽  
Global Development ◽  
Research Support

Abstract Background Invasive aspergillosis (IA) complicates the care of up to 13% of patients with varying forms of immune compromise. The accompanying morbidity and mortality associated with IA remains high. We sought to describe the epidemiology and outcomes for all hospitalizations associated with IA in the United States. Methods We analyzed the National Inpatient Sample (NIS) from the Agency for Healthcare Research and Quality (AHRQ) for 2010–2013. We identified subjects with high-risk conditions for IA (stem cell or solid organ transplant, critical illness, major surgery, mild-to-moderate immune compromise, severe immune compromise, and other [human immunodeficiency virus, pneumonia, chronic obstructive pulmonary disease]). IA was identified via ICD-9-CM codes 117.3, 117.9, and 484.6. We compared characteristics and outcomes between those with (IA) and without IA (non-IA). We calculated the IA-associated excess mortality, length of stay (LOS) and costs using propensity-score (PS) matching. Results Of the 66,634,683 discharges who met the study inclusion criteria, 154,888 (0.2%) had a diagnosis of IA. Patients with IA were more likely to be male (50.9% IA vs. 46.7% non-IA, P &lt; 0.001), and African American (15.3% IA vs. 12.5% non-IA, P &lt; 0.001). The most common high-risk condition among those not classified as IA was major surgery (50.1%). In the IA group critical illness was noted most frequently (41.0%). The burden of both chronic (median [interquartile range, IQR] number of Elixhauser comorbidities 3 [1, 5] non-IA vs. 4 [3, 6] IA, P &lt; 0.001) and acute (median [IQR] number of procedures during the hospitalization 2 [1, 3] non-IA vs. 3 [1, 6] IA, P &lt; 0.001) illnesses was higher in the IA group than the non-IA. After PS-matching, mortality in IA (14.1%) was 37% higher than in non-IA (10.3%, P &lt; 0.001), translating to an odds ratio = 1.43; 95% CI (1.36, 1.51). IA was associated with 6.0 (95% CI 5.7, 6.4) excess days in the hospital and excess $15,542 (95% CI $13,869, $17,215) in costs/hospitalization. Conclusion Although rare even among high-risk groups, IA is associated with high hospital mortality, excess duration of hospitalization, and costs. Given nearly 40,000 annual IA admissions in the United States, we estimate that the aggregate IA-attributable excess costs may reach $600 million annually. Disclosures M. D. Zilberberg, Astellas: Grant Investigator, Research support. B. Nathanson, EviMed, LLC: Consultant, Consulting fee. R. Harrington, Astellas Pharma Global Development, Inc.: Employee, Salary. J. Spalding, Astellas Pharma Global Development, Inc.: Employee, Salary. A. F. Shorr, Astellas: Consultant and Speaker’s Bureau, Consulting fee, Research support and Speaker honorarium. Cidara: Consultant, Consulting fee. Merck: Consultant, Scientific Advisor and Speaker’s Bureau, Research support and Speaker honorarium

Why African Americans Are a Potential Target for COVID-19 Infection in the United States (USA). (Preprint)

2020 ◽  
Author(s):  
Alireza Hamidian Jahromi ◽  
Anahid Hamidianjahromi
Keyword(s):  
United States ◽  
Health Care ◽  
African Americans ◽  
Crisis Management ◽  
Ethnic Minorities ◽  
Risk Groups ◽  
The Elderly ◽  
The United States ◽  
Exponential Phase ◽  
The Impact

UNSTRUCTURED While WHO has officially announced that COVID-19 outbreak reaching a pandemic level, things have significantly changed inside USA, as this infection spread has reached its exponential phase. A stringent analysis of the COVID-19 epidemiologic data requires much more time and would generally be expected to happen after the exponential phase of the disease is over and when the focus of the health-care system is diverted away from crisis-management. Although much is said about high-risk groups and the vulnerability of elderly and patients with underlying comorbidities, the impact of race and its implications on susceptibility of ethnic minorities in indigent societies towards COVID-19 has not been discussed. There are currently some data on disparities between African American and Caucasians for COVID-19 infection and mortality. While the health-care authorities are reorganizing their resources and the infrastructure to provide care for the COVID-19 symptomatic patients, they should not shy away from protecting the general public as a whole and specifically the most vulnerable members of society, such as the elderly, ethnic minorities, and people with underlying comorbidities as well as African Americans.

scholarly journals Nationwide estimate of emergency department visits in the United States related to caustic ingestion

2020 ◽  
Vol 33 (6) ◽  
Author(s):  
Yiting Li ◽  
James Langworthy ◽  
Lan Xu ◽  
Haifeng Cai ◽  
Yingwei Yang ◽  
...  
Keyword(s):  
United States ◽  
Emergency Department ◽  
Substance Use ◽  
Substance Use Disorders ◽  
The United States ◽  
Emergency Department Visits ◽  
Caustic Ingestion ◽  
Multivariable Logistic Regression Model ◽  
Systemic Complications ◽  
Ed Visits

Summary Introduction Caustic ingestion, whether intentional or unintentional, may result in significant morbidity. Our aim was to provide an estimate of the incidence and outcomes of caustic ingestion among emergency department (ED) visits across the United States. Methods The Nationwide Emergency Department Sample (NEDS) is part of the family of databases developed for the Healthcare Cost and Utilization Project. We analyzed NEDS for the period 2010–2014. Adults (≥18 years of age) with a diagnosis of caustic ingestion were identified by ICD-9 codes. The weighted frequencies and proportions of caustic ingestion-related ED visits by demographic characteristics and disposition status were examined. A weighted multivariable logistic regression model was performed to examine factors associated with inpatient admission for caustic ingestion-related visits. Results From 2010 to 2014, there were 40,844 weighted adult ED visits related to caustic ingestion among 533.8 million visits (7.65/100,000, 95% CI 7.58/100,000–7.73/100,000), resulting in over $47 million in annual cost. Among ED visits related to caustic ingestion, 28% had comorbid mental and substance use disorders. Local and systemic complications were rare. There was significant regional, gender, and insurance variability in the decision as to perform endoscopy. Males, insured patients, patients domiciled in the Southeast region of the United States, and patients with mental or substance use disorders had significantly higher percentages of receiving endoscopic procedures. Overall, 6,664 (16.27%) visits resulted in admission to the same hospital and 1,063 (2.60%) visits resulted in transfer to another hospital or facility. The risk factors for admission were increasing in age, male gender, local or systemic complications related to caustic ingestion, and comorbid mental and substance use disorders. A total of 161 (0.39%) patients died related to caustic ingestion. Conclusion Our results from NEDS provide national estimates on the incidence of caustic ingestions involving adults seen in US EDs. Further studies are needed to examine the standard management of caustic ingestion and investigate the factors causing variability of esophagogastroduodenoscopy performance and caustic ingestion care.

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