Risk factors for influenza-related complications in children during the 2009/10 pandemic: a UK primary care cohort study using linked routinely collected data.
Primary care clinicians have a central role in managing influenza/influenza-like illness (ILI) during influenza pandemics. This study identifies risk factors for influenza-related complications in children presenting with influenza/ILI in primary care. We conducted a cohort study using routinely collected linked data from the Clinical Practice Research Datalink on children aged 17 years and younger who presented with influenza/ILI during the 2009/10 pandemic. We calculated odds ratios (ORs) for potential risk factors in relation to influenza-related complications, complications requiring intervention, pneumonia, all-cause hospitalisation and hospitalisation due to influenza-related complications within 30 days of presentation. Analyses were adjusted for potential confounders including age, vaccination and socio-economic deprivation. Asthma was a risk factor for influenza-related complications (adjusted OR 1.48, 95% confidence interval (CI) 1.21-1.80, P < 0.001), complications requiring intervention (adjusted OR 1.44, 95% CI 1.11-1.88; P = 0.007), pneumonia (adjusted OR 1.64, 95% CI 1.07-2.51, P = 0.024) and hospitalisation due to influenza-related complications (adjusted OR 2.46, 95% CI 1.09-5.56, P = 0.031). Neurological conditions were risk factors for all-cause hospitalisation (adjusted OR 4.25, 95% CI 1.50-12.07, P = 0.007) but not influenza-related complications (adjusted OR 1.46, 95% CI 0.83-2.56, P = 0.189). Community-based early interventions to prevent influenza-related clinical deterioration should therefore be primarily targeted at children with asthma and neurological conditions.
['Lee|J J|JJ|https://orcid.org/0000-0002-4033-0915', 'Bankhead|C|C|', 'Smith|M|M|', 'Kousoulis|A A|AA|', 'Butler|C C|CC|', 'Wang|K|K|']
D000293:Adolescent D001249:Asthma D002648:Child D002675:Child, Preschool D015331:Cohort Studies D005260:Female D006760:Hospitalization D006801:Humans D007223:Infant D007231:Infant, Newborn D007251:Influenza, Human D008297:Male D016017:Odds Ratio D058873:Pandemics D011014:Pneumonia D015995:Prevalence D011320:Primary Health Care D012307:Risk Factors D006113:United Kingdom
risk factors Children primary care influenza