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Factors Affecting the Incidence of Hospitalized Pneumonia after Influenza Infection in Korea Using the National Health Insurance Research Database, 2014?2018: Focusing on the Effect of Antiviral Therapy in the 2017 Flu Season

Journal of Korean Medical Science 2020년 35권 38호 p.318 ~ 318
변경향, 김재용, 최보율, 김진용, 이나경,
소속 상세정보
변경향 ( Byeon Kyeong-Hyang ) - Hanyang University College of Medicine Department of Preventive Medicine
김재용 ( Kim Jai-Yong ) - Yonsei University Wonju College of Medicine Institute of Artificial Intelligence and Big Data in Medicine
최보율 ( Choi Bo-Youl ) - Hanyang University College of Medicine Department of Preventive Medicine
김진용 ( Kim Jin-Yong ) - Incheon Medical Center Department of Internal Medicine
이나경 ( Lee Na-Kyoung ) - Hanyang University College of Medicine Department of Preventive Medicine

Abstract


Background: This study aimed to investigate the effect of antiviral therapy following influenza outpatient episodes on the incidence of hospitalized pneumonia episodes, one of secondary complications of influenza.

Methods: In the National Health Insurance Research Database, data from July 2013 to June 2018 were used. All of the claim data with diagnoses of influenza and pneumonia were converted to episodes of care after applying 100 days of window period. With the 100-day episodes of care, the characteristics of influenza outpatient episodes and antiviral therapy for influenza, the incidence of hospitalized pneumonia episodes following influenza, and the effect of antiviral therapy for influenza on hospitalized pneumonia episodes were investigated.

Results: The crude incidence rate of hospitalized pneumonia after influenza infection was 0.57% in both males and females. Factors affecting hospitalized pneumonia included age, income level except self-employed highest (only in females), municipality, medical institution type, precedent chronic diseases except hepatitis (only in females) and antiviral therapy. In the 2017 flu season, the relative risk was 0.38 (95% confidence interval [CI], 0.29?0.50) in males aged 0?9 and 0.43 (95% CI, 0.32?0.57) in females aged 0?9 without chronic diseases, and it was 0.51 (95% CI, 0.42?0.61) in males aged 0?9 and 0.42 (95% CI, 0.35?0.50) in females aged 0?9 with one or more chronic diseases in the aspect of the effect of antiviral therapy on pneumonia. It suggests that antiviral therapy may decrease the incidence of pneumonia after influenza infection.

Conclusion: After outpatient episode incidence of influenza, antiviral treatment has been shown to reduce the incidence of hospitalized pneumonia, especially in infants and children, during pandemic season 2017. Antiviral therapy for influenza is recommended to minimize burden caused by influenza virus infection and to reduce pneumonia. In addition, medical costs of hospitalization may decrease by antiviral therapy, especially in infants and children.

키워드

Influenza; Pneumonia; Antiviral Treatment; Episode of Care

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