Infectious Disease

Decline in perform widespread and protracted in older adults hospitalized with influenza

December 22, 2020

2 min read

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Disclosure:
Andrew reports that she has received grants from the Canadian Frailty Network, GlaxoSmithKline, and Sanofi Pasteur; and has received payments and grants from GlaxoSmithKline, Pfizer, and Sanofi Pasteur. In the study you will find all relevant financial information from all other authors.

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In a study of older adults hospitalized with influenza and other acute respiratory diseases, functional decline was common and, for some, persistent and catastrophic, researchers reported in the Journal of the American Geriatrics Society.

“Although we often think of influenza in terms of its short-term effects, a significant proportion of older adults hospitalized with influenza will experience long-term dysfunction which can significantly affect their quality of life, independence and need for care / support Melissa K. Andrew, MD, PhD, Associate Professor in the Department of Geriatrics at Dalhousie University in Halifax, Nova Scotia, Canada, told Healio.

The prospective observational study enrolled 925 patients (mean age 79 years; 56.1% women) enrolled in the Serious Outcomes Surveillance Network of the Canadian Immunization Research Network during the 2011–2012 influenza season. Patients were admitted to one of 40 hospitals in seven Canadian provinces with influenza and other acute respiratory diseases.

Frailty was measured using a frailty index and functional status was measured using the Barthel index, where moderate persistent functional decline was defined as a clinically meaningful loss of 10 or more to less than 20 points on the 100 point index. A catastrophic disability was defined as a loss of 20 or more points, which corresponds to a complete loss of function in two areas or a need for support in four areas, depending on the study background.

37 percent of the patients had laboratory-confirmed influenza. Compared to patients with other acute respiratory diseases, patients with influenza showed a lower basic function (Barthel index 77 vs. 86.9; P <0.001) and a higher frailty (frailty index 0.23 vs. 0.2; P <0.001). A higher level of basic weakness was associated with an increased likelihood of loss of function, catastrophic disability, and death.

Thirty days after discharge, 18.2% of patients experienced a clinically meaningful loss of function, with half of the study being found to be catastrophic.

The relationship between loss of function and catastrophic disability and frailty is the same in patients with influenza and patients with other acute respiratory diseases, the researchers wrote.

A total of 78 patients died (12.1% with influenza and 6.2% with other acute respiratory diseases), 8.2% of patients had persistent moderate loss of function, and 9.9% of patients had catastrophic disability.

“We should consider functional results in clinical settings and research studies for influenza and other respiratory diseases and infections. Preventing infection and hospitalization, including through vaccination, is critical, ”said Andrew. “We need to consider functional measures and results more consistently when researching influenza and other respiratory diseases and infections, both in clinical studies and in practice. This will be important for many conditions, including COVID-19. “

For more informations:

Melissa K. Andrew, MD, PhD, can be reached at mandrew@dal.ca.

Reference:

Press release.

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