1504 - Risk of Influenza-Associated Hospitalization Among Older Adults Living with Diabetes — United States, 2012–2017

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Presenting Author(s)

Daniel Owusu

Epidemic Intelligence Service Officer
Centers for Disease Control and Prevention
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

MR

Melissa A. Rolfes

Epidemiologist
Centers for Disease Control and Prevention
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CA

Carmen S. Arriola Velezmoro

Research Epidemiologist
Centers for Disease Control and Prevention
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CR

Carrie Reed

Epidemiologist
Centers for Disease Control and Prevention
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
PD

Pam Daily Kirley

Project Manager Viral Respiratory Diseases
California Emerging Infections Program
Oakland, California
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
NA

Nisha B. Alden

Respiratory and Invasive Bacterial Disease Program Manager
Colorado Department of Public Health and Environment
Denver, Colorado
Disclosure: CDC (Grant/Research Support)
Evan J. Anderson

Professor
Emory University School of Medicine
Atlanta, Georgia
Disclosure: Sanofi Pasteur (Scientific Research Study Investigator)
MM

Maya Monroe

Epidemiologist-Respiratory Program Administrator
Maryland Department of Health
Baltimore, Maryland
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SK

Sue Kim

Epidemiologist
Michigan Department of Health and Human Services
Lansing, Michigan
Disclosure: Council of State and Territorial Epidemiologists (CSTE) (Grant/Research Support)
Ruth Lynfield

State Epidemiologist and Medical Director
Minnesota Department of Health
St. Paul, MN
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CM

Chelsea L. McMullen

Respiratory Disease Surveillance Coordinator
New Mexico Department of Health
Santa Fe, New Mexico
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
NS

Nancy L. Spina

Public Health Representative
New York State Department of Health
Albany, New York
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
NB

Nancy M. Bennett

Professor of Medicine and Public Health Sciences
University of Rochester School of Medicine and Dentistry
Rochester, NY
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
LB

Laurie M. Billing

Epidemiologist
Ohio Department of Health
Columbus, Ohio
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AT

Ann Thomas

Public Health Physician
Oregon Health Authority
Portland, Oregon
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
HT

Helen Talbot

Associate Professor
Vanderbuilt University
Nashville, Tennessee
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
KM

Keegan McCaffrey

Epidemiologist
Utah Department of Health
Salt Lake City, UT
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
KY

Kimberly Yousey-Hindes

Epidemiologist 3
Yale School of Public Health
New Haven, Connecticut
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Shikha Garg

Medical Officer
Centers for Disease Control and Prevention
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Background: Older adults account for tens to hundreds of thousands of influenza-associated hospitalizations annually. Diabetes mellitus (DM) is common among patients hospitalized with influenza, yet data are limited on the impact of DM on influenza-associated hospitalizations. We compared influenza-associated hospitalization rates among older adults living with and without DM

Methods: We included adults ≥65 years hospitalized with influenza during 2012–13 through 2016–17 from the Influenza Hospitalization Surveillance Network (FluSurv-Net), a population-based surveillance system for laboratory-confirmed influenza-associated hospitalizations conducted in defined catchment areas within 13 states. Influenza testing is clinician-directed, and surveillance officers identify cases through infection control logs, laboratory records and other disease reporting systems. Data on underlying conditions, including DM, were abstracted from medical records Population denominators were calculated using county-specific estimates of DM prevalence from the Centers for Medicare and Medicaid Services. We calculated hospitalization rates by state and season, and present pooled rates and rate ratios, with 95% confidence intervals (CI), using meta-analysis with state as a random effect.

Results: Of 31,934 patients included in the analysis, 34% had DM. DM prevalence in the FluSurv-Net source population aged ≥65 years was 25%. Accounting for variability by state, the average influenza-associated hospitalization rate per 100,000 person years from 2012-13 through 2016-17 was 276 (95% CI: 230–330/100,000) in those with DM and 181 (95% CI:150–217/100,000) in those without DM. Though the magnitude of the association varied by season, hospitalization rates among those with DM was consistently greater than those without DM (pooled rate ratio: 1.57; 95% CI: 1.43–1.72; P< .0001).

Conclusion: Older adults have high influenza-associated hospitalization rates, and those with DM have a 57% increased risk compared to those without DM. These findings reinforce the importance of annual influenza vaccination in adults ≥65 years of age, particularly those with DM.