Age- and sex-related risk factors for influenza-associated mortality in the United States between 1997-2007
Open accessAbstract
Limited information on age- and sex-specific estimates of influenza-associated death with different underlying causes is currently available. We regressed weekly age- and sex-specific US mortality outcomes underlying several causes between 1997 and 2007 to incidence proxies for influenza A/H3N2, A/H1N1, and B that combine data on influenza-like illness consultations and respiratory specimen testing, adjusting for seasonal baselines and time trends. Adults older than 75 years of age had the highest average annual rate of influenza-associated mortality, with 141.15 deaths per 100,000 people (95% confidence interval (CI): 118.3, 163.9), whereas children under 18 had the lowest average mortality rate, with 0.41 deaths per 100,000 people (95% CI: 0.23, 0.60). In addition to respiratory and circulatory causes, mortality with underlying cancer, diabetes, renal disease, and Alzheimer disease had a contribution from influenza in adult age groups, whereas mortality with underlying septicemia had a contribution from influenza in children. For adults, within several age groups and for several underlying causes, the rate of influenza-associated mortality was somewhat higher in men than in women. Of note, in men 50-64 years of age, our estimate for the average annual rate of influenza-associated cancer mortality per 100,000 persons (1.90, 95% CI: 1.20, 2.62) is similar to the corresponding rate of influenza-associated respiratory deaths (1.81, 95% CI: 1.42, 2.21). Age, sex, and underlying health conditions should be considered when planning influenza vaccination and treatment strategies.
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Risk factors for hospitalisation and death, including age and comorbidities, are consistent with those previously identified for respiratory viruses.
“Risk factors for hospitalisation and death, including age and comorbidities, are consistent with those previously identified for respiratory viruses.121”
From Severe acute respiratory syndrome (SARS) mathematical models and disease parameters: a systematic review (2025) · cites this paper as [121]
The Abstract reports that age predicts influenza-associated death and that deaths occurred with several underlying conditions. The discussion (p. 159) says its findings on elderly deaths and underlying respiratory and circulatory disease are generally consistent with previous work. The paper does not assess risk factors for hospitalisation, and its findings concern influenza rather than respiratory viruses generally. (LLM, conf=0.86)
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- Authors
- Quandelacy, T. M., Viboud, C., Charu, V., Lipsitch, M., & Goldstein, E.
- Affiliations
- Harvard University (US)
- Corresponding author
- Goldstein, Edward
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-11-04
- Volume
- 179
- Issue
- 2
- Pages
- 156-167
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- PMC
- PMC3873104
- OpenAlex
- W2144402463
- Semantic Scholar
- b13ae7df58f22e0addb72022d1045095838faca0
- Cited by
- 144
- References
- 34
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 12 · 2023: 13 · 2022: 14 · 2021: 15 · 2020: 13 · 2019: 14 · 2018: 10 · 2017: 14 · 2016: 9 · 2015: 13 · 2014: 5 · 2013: 1
- FWCI
- 6.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Epidemiology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pfizer
- Johns Hopkins University
- National Institutes of Health
- School of Medicine, Johns Hopkins University
- National Institute of General Medical Sciences (U54GM088558, T32GM007309, award number U54GM088558)
- National Institute of Allergy and Infectious Diseases (K01AI101010)
- Fogarty International Center
- Topics
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Keywords
- influenza-associated deaths, age-specific mortality, sex differences, H3N2, H1N1 influenza, influenza B, influenza-like illness, underlying cause of death, cancer mortality, respiratory mortality, septicemia, children, older adults
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Child, Female, Humans, Influenza, Human, Male, Middle Aged, Pneumonia, Risk Factors, Sex Factors, United States, Alphainfluenzavirus, Betainfluenzavirus, Young Adult
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