Skip to main content
NCBI home page
Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2000 Mar 1;91(2):144–147. doi: 10.1007/BF03404931

Measuring the Impact of Influenza on the Hospital Admission Rates of the Elderly in Ontario: A Five-year Admission Rate Analysis, 1988–1993

R E G Upshur 116,✉, Vivek Goel 216
PMCID: PMC6980017  PMID: 10832182

Abstract

Objective: A retrospective study was conducted to compare age- and sex-specific rates of hospital admission of the elderly in Ontario for five influenza seasons from 1988–1993 for pneumonia, congestive heart failure and chronic respiratory disease.

Results: Significant increases in admissions were found for pneumonia in each influenza season for both sexes. Admissions were significantly increased for congestive heart failure for the oldest males in all years; and for four of five years for the youngest two age groups of males. For females significant increases in admissions occurred in the oldest two age groups in each influenza season; and for three of five seasons for the youngest age group. For chronic respiratory disease, significant increases in admissions were found for each influenza season for all years for the two youngest age groups of males and females.

Conclusion: The impact of influenza is substantial in terms of morbidity in the elderly.

References

  • 1.Canadian Consensus Conference on Influenza. CCDR. 1993;19–17:136–46. [PubMed] [Google Scholar]
  • 2.Glezen WP. Epidemic influenza. Epidemiol Rev. 1996;18(1):64–76. doi: 10.1093/oxfordjournals.epirev.a017917. [DOI] [PubMed] [Google Scholar]
  • 3.Wald TG, Miller BA, Shult P, et al. Can respiratory syncytial virus and influenza A be distinguished clinically in institutionalized older persons? J Am Geriatr Soc. 1995;43:170–74. doi: 10.1111/j.1532-5415.1995.tb06384.x. [DOI] [PubMed] [Google Scholar]
  • 4.Glezen WP. Serious morbidity and mortality associated with influenza epidemics. Epidemiol Rev. 1982;4:25–44. doi: 10.1093/oxfordjournals.epirev.a036250. [DOI] [PubMed] [Google Scholar]
  • 5.Cesario TC, Yousefi S. Viral infections. Clin Geriatr Med. 1992;8(4):735–43. doi: 10.1016/S0749-0690(18)30441-5. [DOI] [PubMed] [Google Scholar]
  • 6.Foy H, Cooney M, Allan I, Kenny G. Rates of pneumonia during influenza epidemics in Seattle, 1964–1975. JAMA. 1979;241(3):253–58. doi: 10.1001/jama.1979.03290290021018. [DOI] [PubMed] [Google Scholar]
  • 7.Strassberg MA, Greenland S, Sorvillo F, et al. Influenza in the elderly: Report of an outbreak and a review of vaccine effectiveness reports. Vaccine. 1986;4(1):38–44. doi: 10.1016/S0264-410X(86)80002-0. [DOI] [PubMed] [Google Scholar]
  • 8.Glezen WP, Decker M, Perrotta DM. Survey of underlying conditions of persons hospitalized with acute respiratory disease during influenza epidemics in Houston, 1978–1981. Am Rev Respir Dis. 1987;136(3):550–55. doi: 10.1164/ajrccm/136.3.550. [DOI] [PubMed] [Google Scholar]
  • 9.Nichol KL, Margolis KL, Wuorenma J, Von Sternberg T. The efficacy and cost effectiveness of vaccination against influenza among elderly persons living in the community. N Engl J Med. 1994;331(12):778–84. doi: 10.1056/NEJM199409223311206. [DOI] [PubMed] [Google Scholar]
  • 10.McBean AM, Babish JD, Warren JL. The impact and cost of influenza in the elderly. Arch Intern Med. 1993;153(18):2105–11. doi: 10.1001/archinte.1993.00410180051005. [DOI] [PubMed] [Google Scholar]
  • 11.Perrotta DM, Decker M, Glezen WP. Acute respiratory disease hospitalization as a measure of impact of epidemic influenza. Am J Epidemiol. 1985;122(3):468–76. doi: 10.1093/oxfordjournals.aje.a114128. [DOI] [PubMed] [Google Scholar]
  • 12.Carrat F, Valleron AJ. Influenza mortality among the elderly in France, 1980–1990: How many deaths may have been avoided through vaccination? J Epidemiol Commun Health. 1995;49(4):419–25. doi: 10.1136/jech.49.4.419. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13.Barker W. Excess pneumonia and influenza associated hospitalization during influenza epidemics in the United States, 1970–1978. Am J Public Health. 1986;76(7):761–64. doi: 10.2105/AJPH.76.7.761. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.Monto A. Studies of the community and family: Acute upper respiratory illness and infection. Epidemiol Rev. 1994;16(2):351–73. doi: 10.1093/oxfordjournals.epirev.a036158. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15.Granton JT, Grossman RF. Communityacquired pneumonia in the elderly patient. Clin Chest Med. 1993;14(3):537–53. [PubMed] [Google Scholar]
  • 16.Gross PA, Quinnan G, Rodstein M, et al. Association of influenza immunization with reduction of mortality in an elderly population: A prospective study. Arch Intern Med. 1988;148(3):562–65. doi: 10.1001/archinte.1988.00380030068015. [DOI] [PubMed] [Google Scholar]
  • 17.Wiselka M. Influenza: Diagnosis, management, and prophylaxis. BMJ. 1994;308:1341–45. doi: 10.1136/bmj.308.6940.1341. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 18.Fedson DS, Wajda E, Nicol JP, et al. Clinical effectiveness of influenza vaccination in Manitoba. JAMA. 1993;270(16):1956–61. doi: 10.1001/jama.1993.03510160074032. [DOI] [PubMed] [Google Scholar]
  • 19.Barker WH, Mullooly J. Influenza vaccination for elderly persons: Reduction in pneumonia and influenza hospitalizations and deaths. JAMA. 1980;244(22):2547–49. doi: 10.1001/jama.1980.03310220045026. [DOI] [PubMed] [Google Scholar]
  • 20.Shann F. Modern vaccines: Pneumococcus and influenza. Lancet. 1990;335:898–901. doi: 10.1016/0140-6736(90)90489-R. [DOI] [PubMed] [Google Scholar]
  • 21.Douglas RG. Prophylaxis and treatment of influenza. N Engl J Med. 1990;322(7):443–50. doi: 10.1056/NEJM199002153220706. [DOI] [PubMed] [Google Scholar]
  • 22.Bentley D. Vaccinations. Clin Geriatr Med. 1992;8(4):745–60. doi: 10.1016/S0749-0690(18)30442-7. [DOI] [PubMed] [Google Scholar]
  • 23.Saah AJ, Neufeld R, Rodstein M, La Montagne J. Influenza vaccine and pneumonia mortality in a nursing home population. Arch Intern Med. 1986;146(12):2353–57. doi: 10.1001/archinte.1986.00360240071013. [DOI] [PubMed] [Google Scholar]
  • 24.Fedson D. Adult immunization: Summary of the National Vaccine Advisory Committee Report. JAMA. 1994;272:1133–37. doi: 10.1001/jama.1994.03520140063039. [DOI] [PubMed] [Google Scholar]
  • 25.Fedson DS, Wajda A, Nicol JP, Roos L. Disparity between influenza vaccination rates and risks for influenza associated hospital discharge and death in Manitoba in 1982–1983. Ann Intern Med. 1992;116(7):550–55. doi: 10.7326/0003-4819-116-7-550. [DOI] [PubMed] [Google Scholar]
  • 26.Foster D, Talsma A, Furomto-Dawson A, et al. Influenza vaccine effectiveness in preventing hospitalization for pneumonia in the elderly. Am J Epidemiol. 1992;136(3):296–307. doi: 10.1093/oxfordjournals.aje.a116495. [DOI] [PubMed] [Google Scholar]
  • 27.Ontario Hospital Association, Ontario Ministry of Health, Hospital Medical Records Institute: Report of the Ontario data quality re-abstraction study. Ontario Hospital Association. 1991. [Google Scholar]
  • 28.Naylor CD, Anderson GM, Goel V. Patterns of Health Care in Ontario: The ICES Practice Atlas. 1st. Ottawa: Canadian Medical Association; 1994. [Google Scholar]
  • 29.Goel V, Williams J, Anderson GM, et al. Patterns of Health Care in Ontario: The ICES Practice Atlas. 2nd. Ottawa: Canadian Medical Association; 1996. [Google Scholar]
  • 30.Schwartz J. Air pollution and hospital admissions for the elderly in Detroit, Michigan. Am J Respir Crit Care Med. 1994;150(3):648–55. doi: 10.1164/ajrccm.150.3.8087333. [DOI] [PubMed] [Google Scholar]
  • 31.Burnett RT, Dales RE, Brook JR, et al. Association between ambient carbon monoxide levels and hospitalizations for congestive heart failure in the elderly in 10 Canadian cities. Epidemiology. 1997;8(2):162–67. doi: 10.1097/00001648-199703000-00007. [DOI] [PubMed] [Google Scholar]
  • 32.Burnett RT, Dales RE, Raizenne ME, et al. Effects of low ambient levels of ozone and sulfates on the frequency of respiratory admissions to Ontario hospitals. Environ Res. 1994;65(2):172–94. doi: 10.1006/enrs.1994.1030. [DOI] [PubMed] [Google Scholar]
  • 33.Upshur REG, Knight K, Goel V. Time series analysis of the relationship between influenza virus and hospital admissions of the elderly in Ontario for pneumonia, chronic lung disease and congestive heart failure. Am J Epidemiol. 1999;149:85–92. doi: 10.1093/oxfordjournals.aje.a009731. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Journal of Public Health = Revue Canadienne de Santé Publique are provided here courtesy of Springer

RESOURCES