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Effect of ethnicity on care pathway and outcomes in patients hospitalized with influenza A(H1N1)pdm09 in the UK

Effect of ethnicity on care pathway and outcomes in patients hospitalized with influenza A(H1N1)pdm09 in the UK
Effect of ethnicity on care pathway and outcomes in patients hospitalized with influenza A(H1N1)pdm09 in the UK

Data were extracted from the case records of UK patients admitted with laboratory-confirmed influenza A(H1N1)pdm09. White and non-White patients were characterized by age, sex, socioeconomic status, pandemic wave and indicators of pre-morbid health status. Logistic regression examined differences by ethnicity in patient characteristics, care pathway and clinical outcomes; multivariable models controlled for potential confounders. Whites (n = 630) and non-Whites (n = 510) differed by age, socioeconomic status, pandemic wave of admission, pregnancy, recorded obesity, previous and current smoking, and presence of chronic obstructive pulmonary disease. After adjustment for a priori confounders non-Whites were less likely to have received pre-admission antibiotics [adjusted odds ratio (aOR) 0·43, 95% confidence interval (CI) 0·28-0·68, P < 0·001) but more likely to receive antiviral drugs as in-patients (aOR 1·53, 95% CI 1·08-2·18, P = 0·018). However, there were no significant differences by ethnicity in delayed admission, severity at presentation for admission, or likelihood of severe outcome.

Adolescent, Adult, Age Factors, Aged, Child, Child, Preschool, Continental Population Groups, Critical Pathways, Ethnic Groups, Female, Healthcare Disparities, Hospitalization, Humans, Infant, Influenza A Virus, H1N1 Subtype, Influenza, Human, Male, Middle Aged, Patient Outcome Assessment, Sex Factors, Socioeconomic Factors, United Kingdom, Young Adult, Journal Article, Research Support, Non-U.S. Gov't
0950-2688
1129-1138
Nyland, G.A.
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McKenzie, B.C.
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Myles, P.R.
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Semple, M.G.
d454cad4-5635-4f44-959c-951fe475ddc7
Lim, W.S.
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Openshaw, P.J.M.
57eb5d17-3fcc-4caf-b5b5-49147d8eb075
Read, R.C.
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Taylor, B.L.
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Brett, S.J.
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McMenamin, J.
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Enstone, J.E.
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Bannister, B.
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Nicholson, K.G.
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Nguyen-Van-Tam, J.S.
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Nyland, G.A.
0d4fa54c-732b-46b4-a5af-653116ca6066
McKenzie, B.C.
a31a238d-63e1-4896-b61c-a16f26301c69
Myles, P.R.
2e5444ba-9740-4144-b47d-819a62c4e4c9
Semple, M.G.
d454cad4-5635-4f44-959c-951fe475ddc7
Lim, W.S.
122cb9cb-734e-4da8-a2a5-cea5dac1f115
Openshaw, P.J.M.
57eb5d17-3fcc-4caf-b5b5-49147d8eb075
Read, R.C.
b5caca7b-0063-438a-b703-7ecbb6fc2b51
Taylor, B.L.
a3d6732c-8c8f-4cd7-9f86-68357a846b54
Brett, S.J.
6c7ed475-916d-4545-98ae-b47ed818a8cb
McMenamin, J.
d3d68e43-5657-410f-9da6-d8ef141f11de
Enstone, J.E.
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Bannister, B.
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Nicholson, K.G.
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Nguyen-Van-Tam, J.S.
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Nyland, G.A., McKenzie, B.C., Myles, P.R., Semple, M.G., Lim, W.S., Openshaw, P.J.M., Read, R.C., Taylor, B.L., Brett, S.J., McMenamin, J., Enstone, J.E., Bannister, B., Nicholson, K.G. and Nguyen-Van-Tam, J.S. (2015) Effect of ethnicity on care pathway and outcomes in patients hospitalized with influenza A(H1N1)pdm09 in the UK. Epidemiology and Infection, 143 (6), 1129-1138. (doi:10.1017/S0950268814001873).

Record type: Article

Abstract

Data were extracted from the case records of UK patients admitted with laboratory-confirmed influenza A(H1N1)pdm09. White and non-White patients were characterized by age, sex, socioeconomic status, pandemic wave and indicators of pre-morbid health status. Logistic regression examined differences by ethnicity in patient characteristics, care pathway and clinical outcomes; multivariable models controlled for potential confounders. Whites (n = 630) and non-Whites (n = 510) differed by age, socioeconomic status, pandemic wave of admission, pregnancy, recorded obesity, previous and current smoking, and presence of chronic obstructive pulmonary disease. After adjustment for a priori confounders non-Whites were less likely to have received pre-admission antibiotics [adjusted odds ratio (aOR) 0·43, 95% confidence interval (CI) 0·28-0·68, P < 0·001) but more likely to receive antiviral drugs as in-patients (aOR 1·53, 95% CI 1·08-2·18, P = 0·018). However, there were no significant differences by ethnicity in delayed admission, severity at presentation for admission, or likelihood of severe outcome.

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Accepted/In Press date: 2 July 2014
e-pub ahead of print date: 1 August 2014
Published date: April 2015
Keywords: Adolescent, Adult, Age Factors, Aged, Child, Child, Preschool, Continental Population Groups, Critical Pathways, Ethnic Groups, Female, Healthcare Disparities, Hospitalization, Humans, Infant, Influenza A Virus, H1N1 Subtype, Influenza, Human, Male, Middle Aged, Patient Outcome Assessment, Sex Factors, Socioeconomic Factors, United Kingdom, Young Adult, Journal Article, Research Support, Non-U.S. Gov't

Identifiers

Local EPrints ID: 416207
URI: http://eprints.soton.ac.uk/id/eprint/416207
ISSN: 0950-2688
PURE UUID: eae03d4a-d882-4839-818b-41a1a777dcad
ORCID for R.C. Read: ORCID iD orcid.org/0000-0002-4297-6728

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Date deposited: 07 Dec 2017 17:30
Last modified: 18 Feb 2021 17:18

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Contributors

Author: G.A. Nyland
Author: B.C. McKenzie
Author: P.R. Myles
Author: M.G. Semple
Author: W.S. Lim
Author: P.J.M. Openshaw
Author: R.C. Read ORCID iD
Author: B.L. Taylor
Author: S.J. Brett
Author: J. McMenamin
Author: J.E. Enstone
Author: B. Bannister
Author: K.G. Nicholson
Author: J.S. Nguyen-Van-Tam

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