Persistent Functional Decline Following Hospitalization with Influenza or Acute Respiratory Illness

Melissa K. Andrew; Sarah MacDonald; Judith Godin; Janet E. McElhaney; Jason LeBlanc; Todd F. Hatchette; William Bowie; Kevin Katz; Allison McGeer; Makeda Semret; Shelly A. McNeil

doi:10.1111/jgs.16950

Persistent Functional Decline Following Hospitalization with Influenza or Acute Respiratory Illness

Melissa K. Andrew, Sarah MacDonald, Judith Godin, Janet E. McElhaney, Jason LeBlanc, Todd F. Hatchette, William Bowie, Kevin Katz, Allison McGeer, Makeda Semret, Shelly A. McNeil

Medicine

Producción científica: Contribución a una revista › Artículo › revisión exhaustiva

47 Citas (Scopus)

Resumen

Background/objectives: Influenza is associated with significant morbidity and mortality, particularly for older adults. Persistent functional decline following hospitalization has important impacts on older adults' wellbeing and independence, but has been under-studied in relation to influenza. We aimed to investigate persistent functional change in older adults admitted to hospital with influenza and other acute respiratory illness (ARI). Design: Protective observational cohort study. Setting: Canadian Immunization Research Network Serious Outcomes Surveillance Network 2011 to 2012 influenza season. Participants: A total of 925 patients aged 65 and older admitted to hospital with influenza and other ARI. Measurements: Influenza was laboratory-confirmed. Frailty was measured using a Frailty index (FI). Functional status was measured using the Barthel index (BI); moderate persistent functional decline was defined as a clinically meaningful loss of ≥10 to <20 points on the 100-point BI. Catastrophic disability (CD) was defined as a loss of ≥20 points, equivalent to full loss of independence in two basic activities of daily living. Results: Five hundred and nineteen (56.1%) were women; mean age was 79.4 (standard deviation=8.4) years. Three hundred and forty-six (37.4%) had laboratory-confirmed influenza. Influenza cases had lower baseline function (BI = 77.0 vs 86.9, P <.001) and higher frailty (FI = 0.23 vs 0.20, P <.001) than those with other ARI. A total of 8.4% died, 8.2% experienced persistent moderate functional decline, and 9.9% experienced CD. Higher baseline frailty was associated with increased odds of experiencing functional decline, CD, and death. The experience of functional decline and CD, and its association with frailty, was the same for influenza and other ARI. Conclusion: Functional loss in hospital is common among older adults; for some this functional loss is persistent and catastrophic. This highlights the importance of prevention and optimal management of acute declines in health, including influenza, to avoid hospitalization. In the case of influenza, for which vaccines exist, this raises the potential of vaccine preventable disability.

Idioma original	English
Páginas (desde-hasta)	696-703
Número de páginas	8
Publicación	Journal of the American Geriatrics Society
Volumen	69
N.º	3
DOI	https://doi.org/10.1111/jgs.16950
Estado	Published - mar. 2021

Nota bibliográfica

Funding Information:
MKA reports grant payments to her institution from the Canadian Frailty Network, Sanofi Pasteur and GSK group of companies for the conduct of this study, and payments and grant funding from the GSK group of companies, Pfizer and Sanofi Pasteur, outside the submitted work. SM and JG report no conflicts. JEM reports payments to her institution from GlaxoSmithKline, Merck, Sanofi, Pfizer, Medicago, and RestorBio outside of the submitted work. JL reports payments to his institution from the GSK group of companies for the conduct of this study, and payments from Pfizer and Merck outside of the submitted work. TFH reports payments from the GSK and Pfizer group of companies, during the conduct of the study. WB has nothing to disclose. KK has nothing to disclose. AM reports payments to her institution from the GSK group of companies for the conduct of this study, and payments from GSK, Seqirus and Sanofi Pasteur, outside the submitted work. MS reports payments from the GSK group of companies and Pfizer, during the conduct of the study. SAM reports payments from the GSK group of companies, during the conduct of the study; and reports payments from Pfizer, GSK, Merck, Novartis, and Sanofi, outside the submitted work.

Funding Information:
This research was funded by the Canadian Frailty Network, which is supported by the Government of Canada through the Network of Centres of Excellence (NCE) program, in partnership with Sanofi Pasteur Canada. Funding for the SOS Network was provided by the Public Health Agency of Canada and the Canadian Institutes of Health Research to the Canadian Immunization Research Network, and through an investigator‐ initiated Collaborative Research Agreement with GlaxoSmithKline Biologicals SA.

Publisher Copyright:
© 2021 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.

ASJC Scopus Subject Areas

Geriatrics and Gerontology

PubMed: MeSH publication types

Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

ODS de las Naciones Unidas

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@article{e4e53ccfc5eb4e6fa6049fe715380b18,

title = "Persistent Functional Decline Following Hospitalization with Influenza or Acute Respiratory Illness",

abstract = "Background/objectives: Influenza is associated with significant morbidity and mortality, particularly for older adults. Persistent functional decline following hospitalization has important impacts on older adults' wellbeing and independence, but has been under-studied in relation to influenza. We aimed to investigate persistent functional change in older adults admitted to hospital with influenza and other acute respiratory illness (ARI). Design: Protective observational cohort study. Setting: Canadian Immunization Research Network Serious Outcomes Surveillance Network 2011 to 2012 influenza season. Participants: A total of 925 patients aged 65 and older admitted to hospital with influenza and other ARI. Measurements: Influenza was laboratory-confirmed. Frailty was measured using a Frailty index (FI). Functional status was measured using the Barthel index (BI); moderate persistent functional decline was defined as a clinically meaningful loss of ≥10 to <20 points on the 100-point BI. Catastrophic disability (CD) was defined as a loss of ≥20 points, equivalent to full loss of independence in two basic activities of daily living. Results: Five hundred and nineteen (56.1%) were women; mean age was 79.4 (standard deviation=8.4) years. Three hundred and forty-six (37.4%) had laboratory-confirmed influenza. Influenza cases had lower baseline function (BI = 77.0 vs 86.9, P <.001) and higher frailty (FI = 0.23 vs 0.20, P <.001) than those with other ARI. A total of 8.4% died, 8.2% experienced persistent moderate functional decline, and 9.9% experienced CD. Higher baseline frailty was associated with increased odds of experiencing functional decline, CD, and death. The experience of functional decline and CD, and its association with frailty, was the same for influenza and other ARI. Conclusion: Functional loss in hospital is common among older adults; for some this functional loss is persistent and catastrophic. This highlights the importance of prevention and optimal management of acute declines in health, including influenza, to avoid hospitalization. In the case of influenza, for which vaccines exist, this raises the potential of vaccine preventable disability.",

author = "Andrew, {Melissa K.} and Sarah MacDonald and Judith Godin and McElhaney, {Janet E.} and Jason LeBlanc and Hatchette, {Todd F.} and William Bowie and Kevin Katz and Allison McGeer and Makeda Semret and McNeil, {Shelly A.}",

note = "Funding Information: MKA reports grant payments to her institution from the Canadian Frailty Network, Sanofi Pasteur and GSK group of companies for the conduct of this study, and payments and grant funding from the GSK group of companies, Pfizer and Sanofi Pasteur, outside the submitted work. SM and JG report no conflicts. JEM reports payments to her institution from GlaxoSmithKline, Merck, Sanofi, Pfizer, Medicago, and RestorBio outside of the submitted work. JL reports payments to his institution from the GSK group of companies for the conduct of this study, and payments from Pfizer and Merck outside of the submitted work. TFH reports payments from the GSK and Pfizer group of companies, during the conduct of the study. WB has nothing to disclose. KK has nothing to disclose. AM reports payments to her institution from the GSK group of companies for the conduct of this study, and payments from GSK, Seqirus and Sanofi Pasteur, outside the submitted work. MS reports payments from the GSK group of companies and Pfizer, during the conduct of the study. SAM reports payments from the GSK group of companies, during the conduct of the study; and reports payments from Pfizer, GSK, Merck, Novartis, and Sanofi, outside the submitted work. Funding Information: This research was funded by the Canadian Frailty Network, which is supported by the Government of Canada through the Network of Centres of Excellence (NCE) program, in partnership with Sanofi Pasteur Canada. Funding for the SOS Network was provided by the Public Health Agency of Canada and the Canadian Institutes of Health Research to the Canadian Immunization Research Network, and through an investigator‐ initiated Collaborative Research Agreement with GlaxoSmithKline Biologicals SA. Publisher Copyright: {\textcopyright} 2021 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.",

year = "2021",

month = mar,

doi = "10.1111/jgs.16950",

language = "English",

volume = "69",

pages = "696--703",

journal = "Journal of the American Geriatrics Society",

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TY - JOUR

T1 - Persistent Functional Decline Following Hospitalization with Influenza or Acute Respiratory Illness

AU - Andrew, Melissa K.

AU - MacDonald, Sarah

AU - Godin, Judith

AU - McElhaney, Janet E.

AU - LeBlanc, Jason

AU - Hatchette, Todd F.

AU - Bowie, William

AU - Katz, Kevin

AU - McGeer, Allison

AU - Semret, Makeda

AU - McNeil, Shelly A.

N1 - Funding Information: MKA reports grant payments to her institution from the Canadian Frailty Network, Sanofi Pasteur and GSK group of companies for the conduct of this study, and payments and grant funding from the GSK group of companies, Pfizer and Sanofi Pasteur, outside the submitted work. SM and JG report no conflicts. JEM reports payments to her institution from GlaxoSmithKline, Merck, Sanofi, Pfizer, Medicago, and RestorBio outside of the submitted work. JL reports payments to his institution from the GSK group of companies for the conduct of this study, and payments from Pfizer and Merck outside of the submitted work. TFH reports payments from the GSK and Pfizer group of companies, during the conduct of the study. WB has nothing to disclose. KK has nothing to disclose. AM reports payments to her institution from the GSK group of companies for the conduct of this study, and payments from GSK, Seqirus and Sanofi Pasteur, outside the submitted work. MS reports payments from the GSK group of companies and Pfizer, during the conduct of the study. SAM reports payments from the GSK group of companies, during the conduct of the study; and reports payments from Pfizer, GSK, Merck, Novartis, and Sanofi, outside the submitted work. Funding Information: This research was funded by the Canadian Frailty Network, which is supported by the Government of Canada through the Network of Centres of Excellence (NCE) program, in partnership with Sanofi Pasteur Canada. Funding for the SOS Network was provided by the Public Health Agency of Canada and the Canadian Institutes of Health Research to the Canadian Immunization Research Network, and through an investigator‐ initiated Collaborative Research Agreement with GlaxoSmithKline Biologicals SA. Publisher Copyright: © 2021 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.

PY - 2021/3

Y1 - 2021/3

N2 - Background/objectives: Influenza is associated with significant morbidity and mortality, particularly for older adults. Persistent functional decline following hospitalization has important impacts on older adults' wellbeing and independence, but has been under-studied in relation to influenza. We aimed to investigate persistent functional change in older adults admitted to hospital with influenza and other acute respiratory illness (ARI). Design: Protective observational cohort study. Setting: Canadian Immunization Research Network Serious Outcomes Surveillance Network 2011 to 2012 influenza season. Participants: A total of 925 patients aged 65 and older admitted to hospital with influenza and other ARI. Measurements: Influenza was laboratory-confirmed. Frailty was measured using a Frailty index (FI). Functional status was measured using the Barthel index (BI); moderate persistent functional decline was defined as a clinically meaningful loss of ≥10 to <20 points on the 100-point BI. Catastrophic disability (CD) was defined as a loss of ≥20 points, equivalent to full loss of independence in two basic activities of daily living. Results: Five hundred and nineteen (56.1%) were women; mean age was 79.4 (standard deviation=8.4) years. Three hundred and forty-six (37.4%) had laboratory-confirmed influenza. Influenza cases had lower baseline function (BI = 77.0 vs 86.9, P <.001) and higher frailty (FI = 0.23 vs 0.20, P <.001) than those with other ARI. A total of 8.4% died, 8.2% experienced persistent moderate functional decline, and 9.9% experienced CD. Higher baseline frailty was associated with increased odds of experiencing functional decline, CD, and death. The experience of functional decline and CD, and its association with frailty, was the same for influenza and other ARI. Conclusion: Functional loss in hospital is common among older adults; for some this functional loss is persistent and catastrophic. This highlights the importance of prevention and optimal management of acute declines in health, including influenza, to avoid hospitalization. In the case of influenza, for which vaccines exist, this raises the potential of vaccine preventable disability.

AB - Background/objectives: Influenza is associated with significant morbidity and mortality, particularly for older adults. Persistent functional decline following hospitalization has important impacts on older adults' wellbeing and independence, but has been under-studied in relation to influenza. We aimed to investigate persistent functional change in older adults admitted to hospital with influenza and other acute respiratory illness (ARI). Design: Protective observational cohort study. Setting: Canadian Immunization Research Network Serious Outcomes Surveillance Network 2011 to 2012 influenza season. Participants: A total of 925 patients aged 65 and older admitted to hospital with influenza and other ARI. Measurements: Influenza was laboratory-confirmed. Frailty was measured using a Frailty index (FI). Functional status was measured using the Barthel index (BI); moderate persistent functional decline was defined as a clinically meaningful loss of ≥10 to <20 points on the 100-point BI. Catastrophic disability (CD) was defined as a loss of ≥20 points, equivalent to full loss of independence in two basic activities of daily living. Results: Five hundred and nineteen (56.1%) were women; mean age was 79.4 (standard deviation=8.4) years. Three hundred and forty-six (37.4%) had laboratory-confirmed influenza. Influenza cases had lower baseline function (BI = 77.0 vs 86.9, P <.001) and higher frailty (FI = 0.23 vs 0.20, P <.001) than those with other ARI. A total of 8.4% died, 8.2% experienced persistent moderate functional decline, and 9.9% experienced CD. Higher baseline frailty was associated with increased odds of experiencing functional decline, CD, and death. The experience of functional decline and CD, and its association with frailty, was the same for influenza and other ARI. Conclusion: Functional loss in hospital is common among older adults; for some this functional loss is persistent and catastrophic. This highlights the importance of prevention and optimal management of acute declines in health, including influenza, to avoid hospitalization. In the case of influenza, for which vaccines exist, this raises the potential of vaccine preventable disability.

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Persistent Functional Decline Following Hospitalization with Influenza or Acute Respiratory Illness

Resumen

Nota bibliográfica

ASJC Scopus Subject Areas

PubMed: MeSH publication types

ODS de las Naciones Unidas

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