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Scientific article
Open access
English

Risk factors for in-hospital mortality and secondary bacterial pneumonia among hospitalized adult patients with community-acquired influenza : a large retrospective cohort study

Published inAntimicrobial resistance and infection control, vol. 12, no. 1, 25
Publication date2023-03-31
First online date2023-03-31
Abstract

Background: Secondary bacterial pneumonia is an important complication of seasonal influenza, but little data is available about impact on death and risk factors. This study identified risk factors for all-cause in-hospital mortality and secondary bacterial pneumonia among hospitalized adult patients with community-acquired influenza.

Methods: A retrospective cohort study was performed at a tertiary teaching hospital in southwest China. The study cohort included all adult hospitalized patients with a laboratory-confirmed, community-acquired influenza virus infection during three consecutive influenza seasons from 2017 to 2020. Cause-specific Cox regression was used to analyze risk factors for mortality and secondary bacterial pneumonia, respectively, accounting for competing events (discharge alive and discharge alive or death without secondary bacterial pneumonia, respectively).

Results: Among 174 patients enrolled in this study, 14.4% developed secondary bacterial pneumonia and 11.5% died during hospitalization. For all-cause in-hospital mortality, time-varying secondary bacterial pneumonia was a direct risk factor of death (cause-specific hazard ratio [csHR] 3.38, 95% confidence interval [CI] 1.25-9.17); underlying disease indirectly increased death risk through decreasing the hazard of being discharged alive (csHR 0.55, 95% CI 0.39-0.77). For secondary bacterial pneumonia, the final model only confirmed direct risk factors: age ≥ 65 years (csHR 2.90, 95% CI 1.27-6.62), male gender (csHR 3.78, 95% CI 1.12-12.84) and mechanical ventilation on admission (csHR 2.96, 95% CI 1.32-6.64).

Conclusions: Secondary bacterial pneumonia was a major risk factor for in-hospital mortality among adult hospitalized patients with community-acquired influenza. Prevention strategies for secondary bacterial pneumonia should target elderly male patients and critically ill patients under mechanical ventilation.

eng
Keywords
  • All-cause in-hospital mortality
  • Risk factors
  • Seasonal influenza
  • Secondary bacterial pneumonia
  • Humans
  • Male
  • Adult
  • Aged
  • Influenza, Human / complications
  • Retrospective Studies
  • Hospital Mortality
  • Pneumonia, Bacterial / complications
  • Community-Acquired Infections
  • Risk Factors
Citation (ISO format)
YI, Guangzhao et al. Risk factors for in-hospital mortality and secondary bacterial pneumonia among hospitalized adult patients with community-acquired influenza : a large retrospective cohort study. In: Antimicrobial resistance and infection control, 2023, vol. 12, n° 1, p. 25. doi: 10.1186/s13756-023-01234-y
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Identifiers
ISSN of the journal2047-2994
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Creation09/25/2023 8:04:28 PM
First validation03/11/2024 8:24:07 AM
Update time03/11/2024 8:24:07 AM
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