GrippeEspagneV1, Main, Exploration, bibRecord, 000006

Effect of vaccination, comorbidities and age on mortality and severe disease associated with influenza during the season 2016-2017 in a Spanish tertiary hospital.

Identifieur interne : 000006 ( Main/Exploration ); précédent : 000005; suivant : 000007

Effect of vaccination, comorbidities and age on mortality and severe disease associated with influenza during the season 2016-2017 in a Spanish tertiary hospital.

Auteurs : Enrique Gutiérrez-González [Espagne] ; José M. Cantero-Escribano [Espagne] ; Lidia Redondo-Bravo [Espagne] ; Isabel San Juan-Sanz [Espagne] ; Ana Robustillo-Rodela [Espagne] ; Emilio Cendejas-Bueno [Espagne] ; Influenza Working Group [Espagne]

Source :

Journal of infection and public health [ 1876-035X ]

RBID : pubmed:30670352

Descripteurs français

KwdFr :
- Adulte d'âge moyen (MeSH), Appréciation des risques (MeSH), Centres de soins tertiaires (MeSH), Comorbidité (MeSH), Espagne (épidémiologie), Facteurs de risque (MeSH), Facteurs âges (MeSH), Femelle (MeSH), Grippe humaine (mortalité), Grippe humaine (prévention et contrôle), Hospitalisation (statistiques et données numériques), Humains (MeSH), Indice de gravité de la maladie (MeSH), Modèles logistiques (MeSH), Mâle (MeSH), Pronostic (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Vaccination (statistiques et données numériques), Vaccins antigrippaux (usage thérapeutique), Épidémies (statistiques et données numériques).
MESH :
- mortalité : Grippe humaine.
- prévention et contrôle : Grippe humaine.
- statistiques et données numériques : Hospitalisation, Vaccination, Épidémies.
- usage thérapeutique : Vaccins antigrippaux.
- épidémiologie : Espagne.
- Adulte d'âge moyen, Appréciation des risques, Centres de soins tertiaires, Comorbidité, Facteurs de risque, Facteurs âges, Femelle, Humains, Indice de gravité de la maladie, Modèles logistiques, Mâle, Pronostic, Sujet âgé, Sujet âgé de 80 ans ou plus.
Wicri :
- geographic : Espagne.

English descriptors

KwdEn :
- Age Factors (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Comorbidity (MeSH), Epidemics (statistics & numerical data), Female (MeSH), Hospitalization (statistics & numerical data), Humans (MeSH), Influenza Vaccines (therapeutic use), Influenza, Human (mortality), Influenza, Human (prevention & control), Logistic Models (MeSH), Male (MeSH), Middle Aged (MeSH), Prognosis (MeSH), Risk Assessment (MeSH), Risk Factors (MeSH), Severity of Illness Index (MeSH), Spain (epidemiology), Tertiary Care Centers (MeSH), Vaccination (statistics & numerical data).
MESH :
- chemical , therapeutic use : Influenza Vaccines.
- geographic , epidemiology : Spain.
- mortality : Influenza, Human.
- prevention & control : Influenza, Human.
- statistics & numerical data : Epidemics, Hospitalization, Vaccination.
- Age Factors, Aged, Aged, 80 and over, Comorbidity, Female, Humans, Logistic Models, Male, Middle Aged, Prognosis, Risk Assessment, Risk Factors, Severity of Illness Index, Tertiary Care Centers.

Abstract

BACKGROUND

Identifying risk factors for complications or death associated with influenza remains crucial to target preventive interventions. Scores like the Charlson comorbidity index (CCI) may be of help. The aims of this study were to assess the effect of vaccination and comorbidities on severe influenza disease and influenza-related death among hospitalized patients during the season 2016/17; and to evaluate the validity of the CCI to predict death among these patients.

METHODS

Data from adult patients (≥18 years old) with influenza infection admitted to La Paz University Hospital (LPUH) were recorded during the 2016/17 epidemic. The effect of influenza vaccine to prevent severe influenza or death was evaluated using multivariate logistic regression models. The area under the curve of the CCI and the age-adjusted CCI were compared to assess the predictive effect on mortality.

RESULTS

A total of 342 adult patients with influenza infection were admitted, of which 83 developed severe influenza and 25 died during hospitalization. There were no differences between patients who survived and those who died concerning the CCI, but the age-adjusted CCI was higher in fatal cases (p-value=0.005). Influenza vaccine had no statistically significant effect on the risk of mortality (p-value=0.162) while age (OR: 1.12, p-value<0.001) and dementia (OR: 3.05, p-value=0.016) proved to be independent predictors for mortality. The seasonal vaccine was found to be protective for severe infection (OR: 0.54, p-value=0.019). The age-adjusted CCI was a better predictor of mortality than the crude CCI.

CONCLUSIONS

Age and dementia are significant independent risk factors for mortality associated with influenza among hospitalized patients. The age-adjusted CCI seems to be a better predictor of mortality than the crude CCI. Influenza vaccine has shown to be effective in preventing severe influenza in the season 2016/17 among hospitalized patients and should be promoted in population at risk.

DOI: 10.1016/j.jiph.2018.11.011
PubMed: 30670352

Affiliations:

Links toward previous steps (curation, corpus...)

to stream Main, to step Corpus: 00027
to stream Main, to step Curation: 000027

Le document en format XML

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<author><name sortKey="Robustillo Rodela, Ana" sort="Robustillo Rodela, Ana" uniqKey="Robustillo Rodela A" first="Ana" last="Robustillo-Rodela">Ana Robustillo-Rodela</name>
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<author><name sortKey="Cendejas Bueno, Emilio" sort="Cendejas Bueno, Emilio" uniqKey="Cendejas Bueno E" first="Emilio" last="Cendejas-Bueno">Emilio Cendejas-Bueno</name>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Age Factors (MeSH)</term>
<term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Comorbidity (MeSH)</term>
<term>Epidemics (statistics & numerical data)</term>
<term>Female (MeSH)</term>
<term>Hospitalization (statistics & numerical data)</term>
<term>Humans (MeSH)</term>
<term>Influenza Vaccines (therapeutic use)</term>
<term>Influenza, Human (mortality)</term>
<term>Influenza, Human (prevention & control)</term>
<term>Logistic Models (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Prognosis (MeSH)</term>
<term>Risk Assessment (MeSH)</term>
<term>Risk Factors (MeSH)</term>
<term>Severity of Illness Index (MeSH)</term>
<term>Spain (epidemiology)</term>
<term>Tertiary Care Centers (MeSH)</term>
<term>Vaccination (statistics & numerical data)</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term>
<term>Appréciation des risques (MeSH)</term>
<term>Centres de soins tertiaires (MeSH)</term>
<term>Comorbidité (MeSH)</term>
<term>Espagne (épidémiologie)</term>
<term>Facteurs de risque (MeSH)</term>
<term>Facteurs âges (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Grippe humaine (mortalité)</term>
<term>Grippe humaine (prévention et contrôle)</term>
<term>Hospitalisation (statistiques et données numériques)</term>
<term>Humains (MeSH)</term>
<term>Indice de gravité de la maladie (MeSH)</term>
<term>Modèles logistiques (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Pronostic (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
<term>Sujet âgé de 80 ans ou plus (MeSH)</term>
<term>Vaccination (statistiques et données numériques)</term>
<term>Vaccins antigrippaux (usage thérapeutique)</term>
<term>Épidémies (statistiques et données numériques)</term>
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<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Influenza Vaccines</term>
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<keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Influenza, Human</term>
</keywords>
<keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Grippe humaine</term>
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<keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Grippe humaine</term>
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<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Epidemics</term>
<term>Hospitalization</term>
<term>Vaccination</term>
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<keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Hospitalisation</term>
<term>Vaccination</term>
<term>Épidémies</term>
</keywords>
<keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Vaccins antigrippaux</term>
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<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Espagne</term>
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<keywords scheme="MESH" xml:lang="en"><term>Age Factors</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Comorbidity</term>
<term>Female</term>
<term>Humans</term>
<term>Logistic Models</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Prognosis</term>
<term>Risk Assessment</term>
<term>Risk Factors</term>
<term>Severity of Illness Index</term>
<term>Tertiary Care Centers</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Appréciation des risques</term>
<term>Centres de soins tertiaires</term>
<term>Comorbidité</term>
<term>Facteurs de risque</term>
<term>Facteurs âges</term>
<term>Femelle</term>
<term>Humains</term>
<term>Indice de gravité de la maladie</term>
<term>Modèles logistiques</term>
<term>Mâle</term>
<term>Pronostic</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>Identifying risk factors for complications or death associated with influenza remains crucial to target preventive interventions. Scores like the Charlson comorbidity index (CCI) may be of help. The aims of this study were to assess the effect of vaccination and comorbidities on severe influenza disease and influenza-related death among hospitalized patients during the season 2016/17; and to evaluate the validity of the CCI to predict death among these patients.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>Data from adult patients (≥18 years old) with influenza infection admitted to La Paz University Hospital (LPUH) were recorded during the 2016/17 epidemic. The effect of influenza vaccine to prevent severe influenza or death was evaluated using multivariate logistic regression models. The area under the curve of the CCI and the age-adjusted CCI were compared to assess the predictive effect on mortality.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>A total of 342 adult patients with influenza infection were admitted, of which 83 developed severe influenza and 25 died during hospitalization. There were no differences between patients who survived and those who died concerning the CCI, but the age-adjusted CCI was higher in fatal cases (p-value=0.005). Influenza vaccine had no statistically significant effect on the risk of mortality (p-value=0.162) while age (OR: 1.12, p-value<0.001) and dementia (OR: 3.05, p-value=0.016) proved to be independent predictors for mortality. The seasonal vaccine was found to be protective for severe infection (OR: 0.54, p-value=0.019). The age-adjusted CCI was a better predictor of mortality than the crude CCI.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>Age and dementia are significant independent risk factors for mortality associated with influenza among hospitalized patients. The age-adjusted CCI seems to be a better predictor of mortality than the crude CCI. Influenza vaccine has shown to be effective in preventing severe influenza in the season 2016/17 among hospitalized patients and should be promoted in population at risk.</p>
</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">30670352</PMID>
<DateCompleted><Year>2019</Year>
<Month>11</Month>
<Day>14</Day>
</DateCompleted>
<DateRevised><Year>2019</Year>
<Month>11</Month>
<Day>14</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1876-035X</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>12</Volume>
<Issue>4</Issue>
<PubDate><MedlineDate>2019 Jul - Aug</MedlineDate>
</PubDate>
</JournalIssue>
<Title>Journal of infection and public health</Title>
<ISOAbbreviation>J Infect Public Health</ISOAbbreviation>
</Journal>
<ArticleTitle>Effect of vaccination, comorbidities and age on mortality and severe disease associated with influenza during the season 2016-2017 in a Spanish tertiary hospital.</ArticleTitle>
<Pagination><MedlinePgn>486-491</MedlinePgn>
</Pagination>
<ELocationID EIdType="pii" ValidYN="Y">S1876-0341(19)30003-6</ELocationID>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jiph.2018.11.011</ELocationID>
<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Identifying risk factors for complications or death associated with influenza remains crucial to target preventive interventions. Scores like the Charlson comorbidity index (CCI) may be of help. The aims of this study were to assess the effect of vaccination and comorbidities on severe influenza disease and influenza-related death among hospitalized patients during the season 2016/17; and to evaluate the validity of the CCI to predict death among these patients.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">Data from adult patients (≥18 years old) with influenza infection admitted to La Paz University Hospital (LPUH) were recorded during the 2016/17 epidemic. The effect of influenza vaccine to prevent severe influenza or death was evaluated using multivariate logistic regression models. The area under the curve of the CCI and the age-adjusted CCI were compared to assess the predictive effect on mortality.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">A total of 342 adult patients with influenza infection were admitted, of which 83 developed severe influenza and 25 died during hospitalization. There were no differences between patients who survived and those who died concerning the CCI, but the age-adjusted CCI was higher in fatal cases (p-value=0.005). Influenza vaccine had no statistically significant effect on the risk of mortality (p-value=0.162) while age (OR: 1.12, p-value<0.001) and dementia (OR: 3.05, p-value=0.016) proved to be independent predictors for mortality. The seasonal vaccine was found to be protective for severe infection (OR: 0.54, p-value=0.019). The age-adjusted CCI was a better predictor of mortality than the crude CCI.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Age and dementia are significant independent risk factors for mortality associated with influenza among hospitalized patients. The age-adjusted CCI seems to be a better predictor of mortality than the crude CCI. Influenza vaccine has shown to be effective in preventing severe influenza in the season 2016/17 among hospitalized patients and should be promoted in population at risk.</AbstractText>
<CopyrightInformation>Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Gutiérrez-González</LastName>
<ForeName>Enrique</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Unidad Docente de Medicina Preventiva y Salud Pública, Escuela Nacional de Sanidad-Instituto de Salud Carlos III, Madrid, Spain. Electronic address: e.gutierrez@isciii.es.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Cantero-Escribano</LastName>
<ForeName>José M</ForeName>
<Initials>JM</Initials>
<AffiliationInfo><Affiliation>Servicio de Medicina Preventiva Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Redondo-Bravo</LastName>
<ForeName>Lidia</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Servicio de Medicina Preventiva Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>San Juan-Sanz</LastName>
<ForeName>Isabel</ForeName>
<Initials>I</Initials>
<AffiliationInfo><Affiliation>Servicio de Medicina Preventiva Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Robustillo-Rodela</LastName>
<ForeName>Ana</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Servicio de Medicina Preventiva Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Cendejas-Bueno</LastName>
<ForeName>Emilio</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Servicio de Microbiología, Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Influenza Working Group</LastName>
<AffiliationInfo><Affiliation>Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2019</Year>
<Month>01</Month>
<Day>19</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>England</Country>
<MedlineTA>J Infect Public Health</MedlineTA>
<NlmUniqueID>101487384</NlmUniqueID>
<ISSNLinking>1876-0341</ISSNLinking>
</MedlineJournalInfo>
<ChemicalList><Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D007252">Influenza Vaccines</NameOfSubstance>
</Chemical>
</ChemicalList>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000367" MajorTopicYN="N">Age Factors</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015897" MajorTopicYN="N">Comorbidity</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D058872" MajorTopicYN="N">Epidemics</DescriptorName>
<QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006760" MajorTopicYN="N">Hospitalization</DescriptorName>
<QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007252" MajorTopicYN="N">Influenza Vaccines</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName>
<QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName>
<QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016015" MajorTopicYN="N">Logistic Models</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011379" MajorTopicYN="N">Prognosis</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D018570" MajorTopicYN="N">Risk Assessment</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D013030" MajorTopicYN="N" Type="Geographic">Spain</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D062606" MajorTopicYN="N">Tertiary Care Centers</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D014611" MajorTopicYN="N">Vaccination</DescriptorName>
<QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Comorbidity</Keyword>
<Keyword MajorTopicYN="N">Influenza vaccine</Keyword>
<Keyword MajorTopicYN="N">Influenza virus</Keyword>
<Keyword MajorTopicYN="N">Mortality</Keyword>
<Keyword MajorTopicYN="N">Severe influenza</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year>
<Month>02</Month>
<Day>12</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="revised"><Year>2018</Year>
<Month>08</Month>
<Day>10</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2018</Year>
<Month>11</Month>
<Day>11</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed"><Year>2019</Year>
<Month>1</Month>
<Day>24</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2019</Year>
<Month>11</Month>
<Day>15</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez"><Year>2019</Year>
<Month>1</Month>
<Day>24</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">30670352</ArticleId>
<ArticleId IdType="pii">S1876-0341(19)30003-6</ArticleId>
<ArticleId IdType="doi">10.1016/j.jiph.2018.11.011</ArticleId>
</ArticleIdList>
</PubmedData>
</pubmed>
<affiliations><list><country><li>Espagne</li>
</country>
<region><li>Communauté de Madrid</li>
</region>
<settlement><li>Madrid</li>
</settlement>
</list>
<tree><country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Gutierrez Gonzalez, Enrique" sort="Gutierrez Gonzalez, Enrique" uniqKey="Gutierrez Gonzalez E" first="Enrique" last="Gutiérrez-González">Enrique Gutiérrez-González</name>
</region>
<name sortKey="Cantero Escribano, Jose M" sort="Cantero Escribano, Jose M" uniqKey="Cantero Escribano J" first="José M" last="Cantero-Escribano">José M. Cantero-Escribano</name>
<name sortKey="Cendejas Bueno, Emilio" sort="Cendejas Bueno, Emilio" uniqKey="Cendejas Bueno E" first="Emilio" last="Cendejas-Bueno">Emilio Cendejas-Bueno</name>
<name sortKey="Influenza Working Group" sort="Influenza Working Group" uniqKey="Influenza Working Group" last="Influenza Working Group">Influenza Working Group</name>
<name sortKey="Redondo Bravo, Lidia" sort="Redondo Bravo, Lidia" uniqKey="Redondo Bravo L" first="Lidia" last="Redondo-Bravo">Lidia Redondo-Bravo</name>
<name sortKey="Robustillo Rodela, Ana" sort="Robustillo Rodela, Ana" uniqKey="Robustillo Rodela A" first="Ana" last="Robustillo-Rodela">Ana Robustillo-Rodela</name>
<name sortKey="San Juan Sanz, Isabel" sort="San Juan Sanz, Isabel" uniqKey="San Juan Sanz I" first="Isabel" last="San Juan-Sanz">Isabel San Juan-Sanz</name>
</country>
</tree>
</affiliations>
</record>

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	Serveur d'exploration sur la grippe en Espagne
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Effect of vaccination, comorbidities and age on mortality and severe disease associated with influenza during the season 2016-2017 in a Spanish tertiary hospital.

Effect of vaccination, comorbidities and age on mortality and severe disease associated with influenza during the season 2016-2017 in a Spanish tertiary hospital.

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