Neuraminidase Inhibitors and Hospital Length of Stay: A Meta-analysis of Individual Participant Data to Determine Treatment Effectiveness Among Patients Hospitalized With Nonfatal 2009 Pandemic Influenza A(H1N1) Virus Infection

作者：Sudhir Venkatesan, Puja Myles, Kirsty J. Bolton, Stella G. Muthuri, Tarig Al Khuwaitir, Ashish Anovadiya, Eduardo Azziz‐Baumgartner, Tahar Bajjou, Matteo Bassetti, Bojana Beovič, Barbara Bertisch, Isabelle Bonmarin, Robert Booy, Víctor Hugo Borja‐Aburto, Heinz Burgmann, Bin Cao, Jordi Carratalà, Tserendorj Chinbayar, Catia Cillóniz, Justin T. Denholm, Samuel R. Dominguez, Péricles Almeida Delfino Duarte, Gal Dubnov‐Raz, Sergio Fanella, Zhancheng Gao, Patrick Gérardin, Maddalena Giannella, Sophie Gubbels, Jethro Herberg, Anjarath Lorena Higuera Iglesias, Peter H. Hoeger, Xiao Yun Hu, Quazi Tarikul Islam, Mirela Foresti Jiménez, Gerben Keijzers, Hossein Khalili, Gabriela Kusznierz, Ilija Kuzman, Eduard Langenegger, Kamran Bagheri Lankarani, Yee‐Sin Leo, Romina Libster, Rita Linko, Faris Madanat, Efstratios Maltezos, Abdullah Mamun, Toshie Manabe, Gökhan Metan, Auksė Mickienė, Dragan Mikić, Kristin G. I. Mohn, Maria E. Oliva, Mehpare Özkan, Dhruv Parekh, Mical Paul, Barbara A. Rath, Samir Refaey, Alejandro Rodríguez, Bünyamin Sertoğullarından, Joanna Skręt‐Magierło, Ayper Somer, Ewa Talarek, Julian W. Tang, Kelvin Kai‐Wang To, Dat Tran, Timothy M. Uyeki, Wendy Vaudry, Tjasa Vidmar, Paul Zarogoulidis, Nisreen Amayiri, Md Robed Amin, Clarissa Baez, Carlos Bantar, Bao Jing, Mazen Mahmoud Barhoush, Ariful Basher, Julie A. Bettinger, Emilio Bouza, İlkay Bozkurt, Elvira Čeljuska-Tošev, Kenny K C Chan, Yu-Sheng Chen, Rebecca Jane Cox, María R. Cuezzo, Wei Cui, Simin Dashti‐Khavidaki, Bin Du, Hicham El Rhaffouli, Hernan Escobar, Agnieszka Florek-Michalska, John Gerrard, Stuart Gormley, Sandra Götberg, Matthias Hoffmann, Behnam Honarvar, Edgar Bautista, Amr Kandeel, Jianmin Hu, Christoph Kemen, Gulam Khandaker, Marian Knight, Evelyn Siew-Chuan Koay, Miroslav Kojić, Koichiro Kudo, Arthur Ming‐Chit Kwan, Idriss Lahlou Amine, Win Mar Kyaw, Leonard Leibovici, Hongru Li, Xiaoli Li, Pei Liu, Tze Ping Loh, Deborough Macbeth, Magdalena Marczyńska, Fabiane Pinto Mastalir, Allison McGeer, Mohsen Moghadami, Lilian Moriconi, Pagbajabyn Nymadawa, Bülent Özbay, Fernando P. Polack, Philippe Guillaume Poliquin, Wolfgang Pöppl, Alberto Rascon Pacheco, Blaž Pečavar, Mahmudur Rahman, Elena Beatriz Sarrouf, Brunhilde Schweiger, Fang Gao Smith, Antoní Torres, Selda Hançerlı Törün, C. B. Tripathi, Daiva Vėlyvytė, Diego Viasus, Qin Yu, Kwok‐Yung Yuen, Wei Zhang, Wei Zuo, Jonathan S. Nguyen‐Van‐Tam · 发表于：The Journal of Infectious Diseases · 年份：2019 · DOI：10.1093/infdis/jiz152 · 被引用次数：37 · 研究领域：Influenza Virus Research Studies、Respiratory viral infections research、Infectious Encephalopathies and Encephalitis

BACKGROUND: The effect of neuraminidase inhibitor (NAI) treatment on length of stay (LoS) in patients hospitalized with influenza is unclear. METHODS: We conducted a one-stage individual participant data (IPD) meta-analysis exploring the association between NAI treatment and LoS in patients hospitalized with 2009 influenza A(H1N1) virus (A[H1N1]pdm09) infection. Using mixed-effects negative binomial regression and adjusting for the propensity to receive NAI, antibiotic, and corticosteroid treatment, we calculated incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Patients with a LoS of <1 day and those who died while hospitalized were excluded. RESULTS: We analyzed data on 18 309 patients from 70 clinical centers. After adjustment, NAI treatment initiated at hospitalization was associated with a 19% reduction in the LoS among patients with clinically suspected or laboratory-confirmed influenza A(H1N1)pdm09 infection (IRR, 0.81; 95% CI, .78-.85), compared with later or no initiation of NAI treatment. Similar statistically significant associations were seen in all clinical subgroups. NAI treatment (at any time), compared with no NAI treatment, and NAI treatment initiated <2 days after symptom onset, compared with later or no initiation of NAI treatment, showed mixed patterns of association with the LoS. CONCLUSIONS: When patients hospitalized with influenza are treated with NAIs, treatment initiated on admission, regardless of time since symptom onset, is associat...