Influenza-associated in-hospital mortality during the 2017/2018 influenza season: a retrospective multicentre cohort stu
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BRIEF REPORT
Influenza‑associated in‑hospital mortality during the 2017/2018 influenza season: a retrospective multicentre cohort study in central Germany Steve Rößler1 · Juliane Ankert1 · Michael Baier2 · Mathias W. Pletz1 · Stefan Hagel1 Received: 12 June 2020 / Accepted: 16 September 2020 © The Author(s) 2020
Abstract The aim of this retrospective cohort study at eight hospitals in Germany was to specify influenza-associated in-hospital mortality during the 2017/2018 flu season, which was the strongest in Germany in the past 30 years. A total of 1560 patients were included in the study. Overall, in-hospital mortality was 6.7% (n = 103), in patients treated in the intensive care unit (n = 161) mortality was 22.4%. The proportion of deceased patients per hospital was between 0% and 7.0%. Influenza was the immediate cause of death in 82.8% (n = 82) of the decedents. Keywords Influenza · In-hospital mortality · Season 2017/2018 · Intensive care
Purpose It is estimated that 5–20% of the population contracts influenza in an average flu season [1]. Among the 30 most relevant infectious diseases in Europe, influenza, with 5.9 infections per 100,000 inhabitants annually, has the highest incidence and the highest mortality (5.89 deaths per 100,000 inhabitants per year) [2]. Approximately one-third of the total burden of all infectious diseases, measured in disability-adjusted life years, is attributable to influenza [2]. However, it has been recognized for many years that influenza is underreported on death certificates. It is, therefore, common practice to estimate mortality attributed to influenza with statistical methods [3]. This so-called excess mortality is obtained by subtracting the expected mortality (i.e. background mortality) from the observed mortality during an influenza season. If an increase in mortality is observed which is significantly higher than background mortality, this is attributed to influenza. For example, according to the Steve Rößler and Juliane Ankert contributed equaly. * Stefan Hagel [email protected]‑jena.de 1
Institute for Infectious Diseases and Infection Control, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
Institute of Medical Microbiology, Jena University Hospital, Jena, Germany
2
Robert Koch Institute (RKI), an estimated 25,100 people in Germany died due to influenza during the 2017/2018 flu season, but only 1674 influenza-associated deaths were officially reported [3]. As in-hospital mortality is not collected as part of RKI influenza surveillance, no data are available on this. However, accurate data on the burden of disease are important for making comparisons with other diseases, e.g., Coronavirus disease 2019 (COVID-19) [4]. Therefore, the primary aim of this study was to specify influenza-associated in-hospital mortality during the 2017/2018 influenza season, the strongest influenza season in the past 30 years. In addition, the need for intensive care support was assessed, an important number to describe severity of disease.
Methods This retros
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