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Early flu treatment shortens hospitalization among seniors
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Older patients who received early antiviral treatment for influenza had shorter hospitalizations and fewer extended care needs, according to recent data.
“[Influenza] can be extremely serious in older people, leading to hospitalization and in some cases long-term disability,” Dan Jernigan, MD, MPH, director of the CDC’s influenza division, said in a press release. “This important study shows that people 65 and older should seek medical care early when they develop [influenza] symptoms.”
Sandra S. Chaves, MD, MSc, also from the CDC’s influenza division, and colleagues collected data from the Influenza Hospitalization Surveillance Network to assess the impact of antiviral treatment on the length of time a patient spends in a skilled nursing home, long-term care facility or rehabilitation institution after hospital discharge. Patients who resided in an institution or facility before hospitalization were excluded.
Sandra S. Chaves
The researchers examined data on 6,593 patients aged 65 years and older who were admitted to one of 250 surveillance hospitals across 13 states from 2010 to 2013 with laboratory-confirmed influenza. More than 5,300 patients with complete data were treated with antiviral agents. Among them, 76% received early treatment, considered no more than 4 days after the onset of illness. The median duration from illness onset to hospital admission was 1 day for patients who were treated early and 4 days for patients treated late.
Eighteen percent of the patients required extended care after discharge from the hospital. The researchers limited their data to patients who were hospitalized no more than 2 days after the onset of illness (n = 2,238) and found that patients who were treated earlier were less likely to need extended care (adjusted OR = 0.38; 95% CI, 0.17-0.85) and were more likely to be discharged earlier from the hospital (aHR = 1.8; 95% CI, 1.43-2.3) compared with patients who were treated 4 or more days from illness onset. In addition, the likelihood of patients needing extended care increased with age, with 10% of patients aged 65 to 74 years requiring extended care vs. 16% of patients aged 75 to 84 years (aOR = 2.12; 95% CI, 1.53-2.93) and 30% of patients aged 85 years or older (aOR = 4.6; 95% CI, 3.3-6.4). The need for extended care also was associated with the presence of neurologic disorders (aOR = 2.05; 95% CI, 1.5-2.8), community-acquired pneumonia (aOR = 1.52; 95% CI, 1.18-1.95) and ICU admission (aOR = 3.27; 95% CI, 2.41-4.42).
Data limited to patients who were hospitalized more than 2 days from the onset of illness (n = 1,976) yielded similar results, with fewer extended care needs (aOR = 0.75; 95% CI, 0.56-0.97) and shorter hospitalizations (aHR = 1.3; 95% CI, 1.2-1.4) among patients who received early treatment vs. late treatment.
“Our study suggests that antiviral treatment initiated [4 or fewer] days of illness onset could lessen the overall impact of influenza and should be emphasized during influenza seasons as an important adjunct to influenza vaccination efforts.” – by Stephanie Viguers
Disclosure: The researchers report no relevant financial disclosures.
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