Volume 17, Number 8—August 2011
Research
Case–Control Study of Risk Factors for Hospitalization Caused by Pandemic (H1N1) 2009
Table A1
Variable |
No. (%) case-patients, n = 302 |
No. (%) controls, n = 603 |
||
OR (95% CI) |
p value |
|||
Sex | ||||
F | 177 (59) | 396 (66) | Referent | |
M |
125 (41) |
207 (34) |
1.4 (1.0–1.8) |
0.0379 |
Age, y | ||||
16–25 | 40 (13) | 61 (10) | 2.4 (1.4–4.1) | |
26–35 | 54 (18) | 92 (15) | 2.1 (1.3–3.5) | |
36–45 | 58 (19) | 111 (18) | 1.9 (1.2–3.1) | |
46–55 | 72 (24) | 111 (18) | 2.3 (1.4–3.8) | |
56–65 | 44 (15) | 105 (17) | 1.5 (0.9–2.5) | |
>65 |
34 (11) |
123 (20) |
Referent |
0.007 |
Area of residence in Sydney | ||||
South East | 34 (11) | 71 (12) | ||
West | 112 (37) | 229 (38) | ||
South West | 123 (41) | 239 (40) | ||
North |
33 (11) |
64 (11) |
||
Aboriginal status | ||||
Nonindigenous | 293 (97) | 596 (99) | Referent | |
Indigenous |
9 (3) |
7 (1) |
2.6 (1–7.1) |
0.0591 |
Body mass index† | ||||
Underweight (<18.5) | 15 (5) | 15 (3) | 3.0 (1.4–6.5) | <0.0001 |
Normal (18.5–24.9) | 85 (30) | 259 (45) | Referent | |
Overweight (25.0–29.9) | 77 (27) | 175 (30) | 1.3 (0.9–1.9) | |
Obese 1 (30–34.9) | 51 (18) | 79 (14) | 2.0 (1.3–3.0) | |
Obese 2 (35–39.9) | 31 (11) | 29 (5) | 3.3 (1.9–5.7) | |
Obese 3 (>40) |
27 (10) |
21 (4) |
3.9 (2.1–7.3) |
|
Concurrent conditions‡ | ||||
Asthma | 114 (38) | 93 (15) | ||
No regular medication | 25 (8) | 48 (8) | 1.4 (0.8–2.4) | <0.0001 |
Regular medication | 89 (29) | 45 (7) | 5.4 (3.6–8.0) | |
Previous hospitalization | 48 (16) | 24 (4) | ||
Heart disease§ | 40 (14) | 41 (7) | 2.1 (1.3–3.3) | 0.0016 |
Heart failure | 8 (20) | 1 (2) | ||
Angina | 10 (25) | 7 (17) | ||
Heart attack | 8 (20) | 9 (22) | ||
Congenital condition | 6 (15) | 4 (10) | ||
Rheumatic fever | 6 (15) | 1 (2) | ||
Kidney disease¶ | 10 (3) | 8 (1) | 2.5 (1.0–6.5) | 0.0522 |
Renal failure | 5 (50) | 4 (50) | ||
Dialysis | 3 (30) | – | ||
Transplant or waiting list | 4 (40) | – | ||
Mental health problem | 53 (18) | 49 (8) | 2.4 (1.6–3.6) | <0.0001 |
Neurologic problem | 24 (8) | 42 (7) | 1.2 (0.7–1.9) | 0.5925 |
Immunosuppression | 30 (10) | 22 (4) | 2.9 (1.6–5.1) | 0.0002 |
Obstructive sleep apnea | 37 (12) | 23 (4) | 3.5 (2.1–6.0) | <0.0001 |
Lung disease | 58 (19) | 31 (5) | 4.4 (2.8–7.0) | <0.0001 |
Regular medication | 39 (67) | 13 (42) | ||
Previous hospitalization | 32 (55) | 11 (35) | ||
Diabetes | 58 (19) | 38 (6) | 3.5 (2.3–5.5) | <0.0001 |
Metabolic disorder | 3 (1) | 7 (1) | 0.9 (0.2–3.3) | 0.8204 |
Liver disease | 23 (8) | 20 (3) | 2.4 (1.3–4.4) | 0.0053 |
Blood disorder | 16 (5) | 16 (3) | 2.1 (1.0–4.2) | 0.0463 |
Pregnancy | 40 (13) | 7 (1) | 13.0 (5.7–29.4) | <0.0001 |
First trimester | 5 (13) | 2 (18) | ||
Second trimester | 7 (18) | 3 (27) | ||
Third trimester |
28 (70) |
2 (18) |
||
Smoking status# | ||||
Nonsmoker | 144 (48) | 372 (62) | Referent | |
Current smoker | 66 (22) | 82 (14) | 2.1 (1.4–3.0) | 0.0002 |
Former smoker |
91 (30) |
149 (25) |
1.6 (1.1–2.2) |
|
Influenza vaccine in 2009** | 107 (36) | 202 (34) | 1.1 (0.8–1.5) | 0.529 |
*OR, odds ratio; CI, confidence interval.
†Groups are not mutually exclusive.
‡Body mass index calculated as weight in kilograms divided by height in meters squared. Data were missing for 16 case-patients and 25 controls.
§Data were missing for 6 case-patients and 12 controls.
¶Data were missing for 2 controls.
#Data were missing for 2 case-patients and 2 controls.
**Vaccination information was missing for 2 case-patients and 1 control.
References
- Centers for Disease Control and Prevention. Swine influenza A (H1N1) infection in two children—southern California, March–April 2009. MMWR Morb Mortal Wkly Rep. 2009;58:400–2.PubMedGoogle Scholar
- Centers for Disease Control and Prevention. Outbreak of swine-origin influenza A (H1N1) virus infection—Mexico, March–April 2009. MMWR Morb Mortal Wkly Rep. 2009;58:467–70.PubMedGoogle Scholar
- Fielding J, Higgins N, Gregory J, Grant K, Catton M, Bergeri I, Pandemic H1N1 influenza surveillance in Victoria, Australia, April–September, 2009. Euro Surveill. 2009;14:pii:19368. PubMedGoogle Scholar
- Libster R, Bugna J, Coviello S, Hijano DR, Dunaiewsky M, Reynoso N, Pediatric hospitalizations associated with 2009 pandemic influenza A (H1N1) in Argentina. N Engl J Med. 2010;362:45–55. DOIPubMedGoogle Scholar
- Jain S, Kamimoto L, Bramley AM, Schmitz AM, Benoit SR, Louie J, Hospitalized patients with 2009 H1N1 influenza in the United States, April–June 2009. N Engl J Med. 2009;361:1935–44. DOIPubMedGoogle Scholar
- Mullooly JP, Bridges CB, Thompson WW, Chen J, Weintraub E, Jackson LA, Influenza- and RSV-associated hospitalizations among adults. Vaccine. 2007;25:846–55. DOIPubMedGoogle Scholar
- Thompson WW, Shay DK, Weintraub E, Brammer L, Cox N, Anderson LJ, Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA. 2003;289:179–86. DOIPubMedGoogle Scholar
- Thompson WW, Shay DK, Weintraub E, Brammer L, Bridges CB, Cox NJ, Influenza-associated hospitalizations in the United States. JAMA. 2004;292:1333–40. DOIPubMedGoogle Scholar
- Babcock HM, Merz LR, Dubberke ER, Fraser VJ. Case–control study of clinical features of influenza in hospitalized patients. Infect Control Hosp Epidemiol. 2008;29:921–6. DOIPubMedGoogle Scholar
- Bridges CB, Winquist AG, Fukuda K, Cox NJ, Singleton JA, Strikas RA, Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2000;49:1–38.PubMedGoogle Scholar
- Cullen G, Martin J, O’Donnell J, Boland M, Canny M, Keane E, Surveillance of the first 205 confirmed hospitalised cases of pandemic H1N1 influenza in Ireland, 28 April–3 October 2009. Euro Surveill. 2009;14:pii:19389. PubMedGoogle Scholar
- Ugarte S, Arancibia F, Soto R. Influenza A pandemics: clinical and organizational aspects: the experience in Chile. Crit Care Med. 2010;38(Suppl):e133–7. DOIPubMedGoogle Scholar
- Strategic Advisory Group of Experts on Immunization—report of the extraordinary meeting on the influenza A (H1N1) 2009 pandemic, 7 July 2009. Wkly Epidemiol Rec. 2009;84:301–4.PubMedGoogle Scholar
- Castro-Jiménez MÁ, Castillo-Pabón JO, Rey-Benito GJ, Pulido-Domínquez PA, Barbosa-Ramírez J, Velandia-Rodriquez DA, Epidemiologic analysis of the laboratory-confirmed cases of influenza A(H1N1)v in Colombia. Euro Surveill. 2009;14:19284.PubMedGoogle Scholar
- Novel influenza A(H1N1) Investigation Team. Description of the early stage of pandemic (H1N1) 2009 in Germany, 27 April–16 June 2009. Euro Surveill. 2009;14:pii:19295.
- Kumar A, Zarychanski R, Pinto R, Cook DJ, Marshall J, Lacroix J, Critically ill patients with 2009 influenza A(H1N1) infection in Canada. JAMA. 2009;302:1872–9. DOIPubMedGoogle Scholar
- Domínguez-Cherit G, Lapinsky SE, Macias AR, Pinto R, Espinosa-Perez L, de la Torre A, Critically ill patients with 2009 influenza A (H1N1) in Mexico. JAMA. 2009;302:1880–7. DOIPubMedGoogle Scholar
- Louie JK, Acosta M, Winter K, Jean C, Gavali S, Schechter R, Factors associated with death or hospitalization due to pandemic 2009 influenza A(H1N1) infection in California. JAMA. 2009;302:1896–902. DOIPubMedGoogle Scholar
- ANZIC Influenza Investigators; Webb SA, Pettilä V, Seppelt I, Bellomo R, Bailey M, Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med. 2009;361:1925–34. DOIPubMedGoogle Scholar
- Centers for Disease Control and Prevention. Patients hospitalized with 2009 pandemic influenza A (H1N1)—New York City, May 2009. MMWR Morb Mortal Wkly Rep. 2009;58:1436–40.PubMedGoogle Scholar
- Government of New South Wales. Public Health Act 1991 [cited 2009 Dec 15]. http://www.legislation.nsw.gov.au/viewtop/inforce/act+10+1991+FIRST+0+N
- New South Wales public health response guidelines: H1N1 influenza 09 Infection Protect Phase [cited 2009 Dec 15]. http://www.health.nsw.gov.au/factsheets/guideline/swine_flu.html
- Australian Department of Health and Ageing. Protect Phase—Annex to the Australian Health Management Plan for Pandemic Influenza, version 3.0, 21 September 2009 [cited 2009 Dec 15]. http://www.healthemergency.gov.au/internet/healthemergency/publishing.nsf/Content/protect-annex
- Barr M, Baker D, Gorringe M, Fritsche L. NSW Population Health Survey: description of methods. Sydney: Centre for Epidemiology and Research, NSW Department of Health, 2008 [cited 2010 Feb 18]. http://www.health.nsw.gov.au/resources/publichealth/surveys/health_survey_method.asp
- Rizzo C, Rota MC, Bella A, Alfonsi V, Declich S, Caporali MG, Cross-reactive antibody responses to the 2009 A/H1N1v influenza virus in the Italian population in the pre-pandemic period. Vaccine. 2010;28:3558–62. DOIPubMedGoogle Scholar
- Hewagama S, Walker SP, Stuart RL, Gordon C, Johnson PD, Friedman ND, 2009 H1N1 influenza A and pregnancy outcomes in Victoria, Australia. Clin Infect Dis. 2010;50:686–90. DOIPubMedGoogle Scholar
- Rasmussen SA, Jamieson DJ, Bresee JS. Pandemic influenza and pregnant women. Emerg Infect Dis. 2008;14:95–100. DOIPubMedGoogle Scholar
- Jamieson DJ, Honein M, Rasmussen SA, Williams JL, Swerdlow DL, Biggerstaff MS, H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet. 2009;374:451–8. DOIPubMedGoogle Scholar
- Creanga AA, Johnson TF, Graitcer SB, Harman LK, Al-Samarrai T, Schwarz AG, Severity of 2009 pandemic influenza A (H1N1) virus infection in pregnant women. Obstet Gynecol. 2010;115:717–26. DOIPubMedGoogle Scholar
- Simonsen L, Clarke MJ, Schonberger LB, Arden NH, Cox NJ, Fukuda K. Pandemic versus epidemic influenza mortality: a pattern of changing age distribution. J Infect Dis. 1998;178:53–60.PubMedGoogle Scholar
- La Ruche G, Tarantola A, Barboza P, Vaillant L, Gueguen J, Gastellu-Etchegorry M, The 2009 pandemic H1N1 influenza and indigenous populations of the Americas and the Pacific. Euro Surveill. 2009;14:pii:19366. PubMedGoogle Scholar
Page created: August 15, 2011
Page updated: August 15, 2011
Page reviewed: August 15, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.