Background : WHO recommend the surveillance of ILI (Influenza-like Illness) and SARI (Severe Acute Respiratory infection) to respond effectively to both seasonal influenza epidemics and pandemic. In Korea, ¡®Hospital-based Influenza Morbidity and Mortality (HIMM)¡¯ surveillance system has been operated to monitor ILI or SARI occurrence.
Methods: A multi-center prospective observational study was conducted. Patients with acute respiratory infection (ARI) were enrolled during 2011-12, 12-13 and 13-14 flu seasons at the 10 tertiary university hospitals of HIMM surveillance system. With respect to SARI and pneumonia development, risk profiles were analyzed in patients with ARI.
Results: Among enrolled cases, 750 cases belonged to SARI group, while 4709 cases were non-SARI group. With respect to pneumonia development, 317 cases were accompanied by pneumonia, and 5142 cases were non-pneumonia group. Old age over 65 years (OR 2.69,95% CI 2.2-3.32), chronic heart disease (CHD)(OR 2.24, 95% CI 1.68-2.98), cerebrovascular diseases (CVD) (OR 1.49, 95% CI 1.05-2.10), chronic obstructive pulmonary diseases (COPD) (OR 2.34, 95% CI 1.48-3.69), asthma (OR 2.33, 95% CI 1.62-3.36), chronic kidney diseases (CKD) (OR 2.62, 95% CI 1.73-3.99), chronic liver disease (OR 1.71, 95% CI 1.04-2.81) and autoimmune diseases (OR 2.53, 1.57-4.08) were associated with increased risk of SARI on multivariate analyses. Old age (¡Ã65 years) (OR 5.71, 95% CI 4.10-7.94), CHD 1.54, 95% CI 1.07-2.22), COPD (OR 2.34, 95% CI 1.48-3.69), asthma (OR 2.33, 95% CI 1.62-3.36), CKD (OR 2.62, 95% CI 1.73-3.99), immunocompromised conditions (OR 3.12, 95% CI 1.47-6.62) and autoimmune diseases (OR 3.35, 95% C.I 1.79-6.27) were independent risk factors for pneumonia development on multivariate analyses. The risk (Odds ratio) of SARI and pneumonia was increased by the number of concurrent chronic medical conditions (Figure 1).
Conclusion : Elderly people with chronic medical conditions were more likely to be complicated by SARI and pneumonia after acute respiratory infection. Patients with multiple chronic medical conditions were at higher risk in relation to the number of comorbidities.
S. H. Kang,
H. J. Cheong, None
J. Y. Song, None
J. Y. Noh, None
E. J. Jeong, None
J. H. Jeon, None
M. J. Choi, None
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