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首页> 外文期刊>Online Journal of Public Health Informatics >Respiratory and circulatory deaths attributable to influenza A & B
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Respiratory and circulatory deaths attributable to influenza A & B

机译：甲型和乙型流感引起的呼吸道和循环系统死亡

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Objective To estimate mortality attributable to influenza adjusted for other common respiratory pathogens, baseline seasonal trends and extreme temperatures. Introduction Assigning causes of deaths to seasonal infectious diseases is difficult in part due to laboratory testing prior to death being uncommon. Since influenza (and other common respiratory pathogens) are therefore notoriously underreported as a (contributing) cause of death in death- cause statistics modeling studies are commonly used to estimate the impact of influenza on mortality. Methods Using primary cause of death (Statistics Netherlands) we modeled weekly timeseries of 1) respiratory deaths (ICD10 codes J00-J99) and 2) circulatory deaths (ICD10 codes I00-I99). We used regression models with an identity link and Poisson error to relate mortality to counts of influenza A & B diagnoses. We adjusted for other common respiratory pathogens (all pathogen data was at population level from the national laboratory surveillance), temperature (from the Dutch Royal Meteorological Institute), and baseline linear and cyclical (i.e. seasonal) trends. To account for the yearly variation in the severity of the main circulating influenza A strain we used time dependent variables for influenza A (fixed at lag 0 a?? assuming a direct effect of influenza. For influenza B and the confoundig pathogens we considered a 0 tot -4 time lag (thus allowing infection to precede death for up to 4 weeks). We performed the analyses separately per death cause group and by 3 different age groups (0-64, 65-74,75+ years) over a 14-year time- period (mid 1999-mid 2013, thus 14 complete winter seasons). Results In the Netherlands on average 2,636 all cause deaths occur per week varying by season (lower in summer min: 2,219 and higher in winter max: 3,564) with yearly incidence ranging from 20/10,000 in 0-64 year olds to 885/10,000 in 75-plus year olds. Circulatory mortality (31% of total deaths) was higher than respiratory mortality (10% of total deaths) and both showed clear seasonality in all age-groups. Overall, 0.14% of all deaths were actually coded as influenza deaths. Preliminary model estimates showed that the proportion of respiratory deaths attributable to influenza A were quite similar for 0-64 and 65-74 year olds but higher in 75+ (5.1%, 5.7%, 7.0% respectively) while this proportion was stable across age-groups for circulatory deaths (approximately 1.5% in all agegroups for influenza A). Influenza B was significantly associated with respiratory deaths and circulatory deaths in the oldest age group of 75+ years (with proportions of 0.7% and 0.2% respectively) while in the 65-74 year olds it was associated only with circulatory deaths (0.2%). Influenza B was not significantly associated with either respiratory or circulatory mortality in the 0-64 year age group. On average, yearly in the 75+ age group 70/10,000 respiratory deaths and 39/10,000 circulatory deaths were attributable to influenza A. For influenza B the incidences were 7 to 10 fold lower (7/10,000 and 6/10,000 respectively). Conclusions Influenza A was significantly associated with respiratory and circulatory mortality in all age groups while influenza B was significantly associated with respiratory and circulatory mortality in the elderly only.
机译：目的评估经其他常见呼吸道病原体，基线季节性趋势和极端温度调整后的流感造成的死亡率。简介很难将死亡原因归因于季节性传染病，部分原因是在死亡前罕见的实验室检测。由于众所周知，由于流行性感冒（和其他常见的呼吸道病原体）在致死原因中被低估为致死原因，统计学建模研究通常用于估计流行性感冒对死亡率的影响。方法使用主要死亡原因（荷兰统计局）对每周时间序列建模：1）呼吸道死亡（ICD10代码J00-J99）和2）循环系统死亡（ICD10代码I00-I99）。我们使用具有身份关联和Poisson误差的回归模型，将死亡率与A型和A型流感的计数联系起来。 B诊断。我们调整了其他常见的呼吸道病原体（所有病原体数据均来自国家实验室监控的人口水平），温度（来自荷兰皇家气象学院）以及基线线性和周期性（即季节性）趋势。为了说明主要流行的甲型流感病毒株的严重程度的年度变化，我们使用了甲型流感病毒的时间相关变量（假定为甲型流感的直接影响，固定在滞后0 a ??。对于乙型流感和混杂病原体，我们认为是0 tot -4时间滞后（因此允许感染在死亡之前长达4周）我们对每个死亡原因组和3个不同年龄组（0-64岁，65-74,75岁以上）分别进行了14个月的分析年时间段（1999年中至2013年中，因此有14个完整的冬季）结果在荷兰平均每周有2636人死于死亡，且因季节而异（夏季最低者：2,219;冬季最高者：3,564）年发病率从0-64岁的20 / 10,000到75岁以上的885 / 10,000不等，循环死亡率（占总死亡人数的31％）高于呼吸道疾病（占总死亡人数的10％），两者均显示出明显的各个年龄段的季节性。总体而言，所有死亡人数中的0.14％实际上是的流感死亡。初步模型估算显示，0-64岁和65-74岁人群归因于甲型流感的呼吸道疾病死亡比例非常相似，但75岁以上人群分别为5.1％，5.7％和7.0％，而这一比例在各个年龄段中都是稳定的循环死亡的人群（在所有年龄组中，甲型流感的比例约为1.5％）。在75岁以上的年龄最大的人群中，乙型流感与呼吸系统疾病和循环系统死亡显着相关（分别占0.7％和0.2％的比例），而在65-74岁的人群中，乙型流感仅与循环系统死亡（0.2％）相关。 。在0-64岁年龄段，乙型流感与呼吸道或循环系统死亡率均无显着相关。平均而言，在75岁以上的年龄组中，甲型流感可导致70 / 10,000例呼吸系统死亡和39 / 10,000例循环性死亡。对于乙型流感，发病率要低7到10倍（分别为7 / 10,000和6 / 10,000）。结论在所有年龄组中，甲型流感与呼吸和循环系统死亡率均显着相关，而乙型流感仅与老年人显着相关。

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