Risk of winter hospitalisation and death from acute respiratory infections in Scotland: national retrospective cohort study

Ting Shi; Tristan Millington; Chris Robertson; Karen Jeffrey; Srinivasa Vittal Katikireddi; Colin McCowan; Colin R Simpson; Lana Woolford; Luke Daines; Steven Kerr; Ben Swallow; Adeniyi Fagbamigbe; Catalina A Vallejos; David Weatherill; Sandra Jayacodi; Kimberly Marsh; Jim McMenamin; Igor Rudan; Lewis Duthie Ritchie; Tanja Mueller; Amanj Kurdi; Aziz Sheikh; Public Health Scotland and the EAVE II Collaborators

doi:10.1177/01410768231223584

Risk of winter hospitalisation and death from acute respiratory infections in Scotland: national retrospective cohort study

Ting Shi, Tristan Millington, Chris Robertson, Karen Jeffrey, Srinivasa Vittal Katikireddi, Colin McCowan, Colin R Simpson, Lana Woolford, Luke Daines, Steven Kerr, Ben Swallow, Adeniyi Fagbamigbe, Catalina A Vallejos, David Weatherill, Sandra Jayacodi, Kimberly Marsh, Jim McMenamin, Igor Rudan, Lewis Duthie Ritchie, Tanja MuellerAmanj Kurdi, Aziz Sheikh^* (Corresponding Author), Public Health Scotland and the EAVE II Collaborators

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVES: We undertook a national analysis to characterise and identify risk factors for acute respiratory infections (ARIs) resulting in hospitalisation during the winter period in Scotland.

DESIGN: A population-based retrospective cohort analysis.

SETTING: Scotland.

PARTICIPANTS: The study involved 5.4 million residents in Scotland.

MAIN OUTCOME MEASURES: Cox proportional hazard models were used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the association between risk factors and ARI hospitalisation.

RESULTS: Between 1 September 2022 and 31 January 2023, there were 22,284 (10.9% of 203,549 with any emergency hospitalisation) ARI hospitalisations (1759 in children and 20,525 in adults) in Scotland. Compared with the reference group of children aged 6-17 years, the risk of ARI hospitalisation was higher in children aged 3-5 years (aHR = 4.55; 95% CI: 4.11-5.04). Compared with those aged 25-29 years, the risk of ARI hospitalisation was highest among the oldest adults aged ≥80 years (aHR = 7.86; 95% CI: 7.06-8.76). Adults from more deprived areas (most deprived vs. least deprived, aHR = 1.64; 95% CI: 1.57-1.72), with existing health conditions (≥5 vs. 0 health conditions, aHR = 4.84; 95% CI: 4.53-5.18) or with history of all-cause emergency admissions (≥6 vs. 0 previous emergency admissions, aHR = 7.53; 95% CI: 5.48-10.35) were at a higher risk of ARI hospitalisations. The risk increased by the number of existing health conditions and previous emergency admission. Similar associations were seen in children.

CONCLUSIONS: Younger children, older adults, those from more deprived backgrounds and individuals with greater numbers of pre-existing conditions and previous emergency admission were at increased risk for winter hospitalisations for ARI.

Original language	English
Journal	Journal of the Royal Society of Medicine
Early online date	12 Feb 2024
DOIs	https://doi.org/10.1177/01410768231223584
Publication status	E-pub ahead of print - 12 Feb 2024

Bibliographical note

Our thanks to the EAVE II Patient Advisory Group for their support. Additional support has been provided through Public Health Scotland and Scottish Government DG Health and Social Care and the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation. We also thank Vicky Hammersley, Paula Mika and Gabriella Lining for their support with project management and administration. We acknowledge James Osmond from Department of Health and Social Care for his inputs on providing ICD-10 codes and comments.

AS, CR and TS conceived this study. AS, CR, TS and TM commented on the article, oversaw the analysis and edited the final article. TS and AS led the writing of the article. TM led the data analysis with support from CR, BS and AF. All authors contributed to the study design. All authors contributed to drafting the article and revised the article for important intellectual content. All authors had final responsibility for the decision to submit for publication.

Keywords

epidemiology
health informatics
respiratory medicine

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Shi_etal_JRSM_Risk_winter_hospitalisation_AAM
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Shi, T., Millington, T., Robertson, C., Jeffrey, K., Katikireddi, S. V., McCowan, C., Simpson, C. R., Woolford, L., Daines, L., Kerr, S., Swallow, B., Fagbamigbe, A., Vallejos, C. A., Weatherill, D., Jayacodi, S., Marsh, K., McMenamin, J., Rudan, I., Ritchie, L. D., ... Public Health Scotland and the EAVE II Collaborators (2024). Risk of winter hospitalisation and death from acute respiratory infections in Scotland: national retrospective cohort study. Journal of the Royal Society of Medicine. Advance online publication. https://doi.org/10.1177/01410768231223584

Shi, T, Millington, T, Robertson, C, Jeffrey, K, Katikireddi, SV, McCowan, C, Simpson, CR, Woolford, L, Daines, L, Kerr, S, Swallow, B, Fagbamigbe, A, Vallejos, CA, Weatherill, D, Jayacodi, S, Marsh, K, McMenamin, J, Rudan, I, Ritchie, LD, Mueller, T, Kurdi, A, Sheikh, A & Public Health Scotland and the EAVE II Collaborators 2024, 'Risk of winter hospitalisation and death from acute respiratory infections in Scotland: national retrospective cohort study', Journal of the Royal Society of Medicine. https://doi.org/10.1177/01410768231223584

@article{4e31c5ad2b6b45b397d3607bfad7f37f,

title = "Risk of winter hospitalisation and death from acute respiratory infections in Scotland: national retrospective cohort study",

abstract = "OBJECTIVES: We undertook a national analysis to characterise and identify risk factors for acute respiratory infections (ARIs) resulting in hospitalisation during the winter period in Scotland.DESIGN: A population-based retrospective cohort analysis.SETTING: Scotland.PARTICIPANTS: The study involved 5.4 million residents in Scotland.MAIN OUTCOME MEASURES: Cox proportional hazard models were used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the association between risk factors and ARI hospitalisation.RESULTS: Between 1 September 2022 and 31 January 2023, there were 22,284 (10.9% of 203,549 with any emergency hospitalisation) ARI hospitalisations (1759 in children and 20,525 in adults) in Scotland. Compared with the reference group of children aged 6-17 years, the risk of ARI hospitalisation was higher in children aged 3-5 years (aHR = 4.55; 95% CI: 4.11-5.04). Compared with those aged 25-29 years, the risk of ARI hospitalisation was highest among the oldest adults aged ≥80 years (aHR = 7.86; 95% CI: 7.06-8.76). Adults from more deprived areas (most deprived vs. least deprived, aHR = 1.64; 95% CI: 1.57-1.72), with existing health conditions (≥5 vs. 0 health conditions, aHR = 4.84; 95% CI: 4.53-5.18) or with history of all-cause emergency admissions (≥6 vs. 0 previous emergency admissions, aHR = 7.53; 95% CI: 5.48-10.35) were at a higher risk of ARI hospitalisations. The risk increased by the number of existing health conditions and previous emergency admission. Similar associations were seen in children.CONCLUSIONS: Younger children, older adults, those from more deprived backgrounds and individuals with greater numbers of pre-existing conditions and previous emergency admission were at increased risk for winter hospitalisations for ARI.",

keywords = "epidemiology, health informatics, respiratory medicine",

author = "Ting Shi and Tristan Millington and Chris Robertson and Karen Jeffrey and Katikireddi, {Srinivasa Vittal} and Colin McCowan and Simpson, {Colin R} and Lana Woolford and Luke Daines and Steven Kerr and Ben Swallow and Adeniyi Fagbamigbe and Vallejos, {Catalina A} and David Weatherill and Sandra Jayacodi and Kimberly Marsh and Jim McMenamin and Igor Rudan and Ritchie, {Lewis Duthie} and Tanja Mueller and Amanj Kurdi and Aziz Sheikh and {Public Health Scotland and the EAVE II Collaborators}",

note = "Our thanks to the EAVE II Patient Advisory Group for their support. Additional support has been provided through Public Health Scotland and Scottish Government DG Health and Social Care and the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation. We also thank Vicky Hammersley, Paula Mika and Gabriella Lining for their support with project management and administration. We acknowledge James Osmond from Department of Health and Social Care for his inputs on providing ICD-10 codes and comments. AS, CR and TS conceived this study. AS, CR, TS and TM commented on the article, oversaw the analysis and edited the final article. TS and AS led the writing of the article. TM led the data analysis with support from CR, BS and AF. All authors contributed to the study design. All authors contributed to drafting the article and revised the article for important intellectual content. All authors had final responsibility for the decision to submit for publication. ",

year = "2024",

month = feb,

day = "12",

doi = "10.1177/01410768231223584",

language = "English",

journal = "Journal of the Royal Society of Medicine",

issn = "0141-0768",

publisher = "SAGE Publications Ltd",

}

TY - JOUR

T1 - Risk of winter hospitalisation and death from acute respiratory infections in Scotland

T2 - national retrospective cohort study

AU - Shi, Ting

AU - Millington, Tristan

AU - Robertson, Chris

AU - Jeffrey, Karen

AU - Katikireddi, Srinivasa Vittal

AU - McCowan, Colin

AU - Simpson, Colin R

AU - Woolford, Lana

AU - Daines, Luke

AU - Kerr, Steven

AU - Swallow, Ben

AU - Fagbamigbe, Adeniyi

AU - Vallejos, Catalina A

AU - Weatherill, David

AU - Jayacodi, Sandra

AU - Marsh, Kimberly

AU - McMenamin, Jim

AU - Rudan, Igor

AU - Ritchie, Lewis Duthie

AU - Mueller, Tanja

AU - Kurdi, Amanj

AU - Sheikh, Aziz

AU - Public Health Scotland and the EAVE II Collaborators

N1 - Our thanks to the EAVE II Patient Advisory Group for their support. Additional support has been provided through Public Health Scotland and Scottish Government DG Health and Social Care and the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation. We also thank Vicky Hammersley, Paula Mika and Gabriella Lining for their support with project management and administration. We acknowledge James Osmond from Department of Health and Social Care for his inputs on providing ICD-10 codes and comments. AS, CR and TS conceived this study. AS, CR, TS and TM commented on the article, oversaw the analysis and edited the final article. TS and AS led the writing of the article. TM led the data analysis with support from CR, BS and AF. All authors contributed to the study design. All authors contributed to drafting the article and revised the article for important intellectual content. All authors had final responsibility for the decision to submit for publication.

PY - 2024/2/12

Y1 - 2024/2/12

N2 - OBJECTIVES: We undertook a national analysis to characterise and identify risk factors for acute respiratory infections (ARIs) resulting in hospitalisation during the winter period in Scotland.DESIGN: A population-based retrospective cohort analysis.SETTING: Scotland.PARTICIPANTS: The study involved 5.4 million residents in Scotland.MAIN OUTCOME MEASURES: Cox proportional hazard models were used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the association between risk factors and ARI hospitalisation.RESULTS: Between 1 September 2022 and 31 January 2023, there were 22,284 (10.9% of 203,549 with any emergency hospitalisation) ARI hospitalisations (1759 in children and 20,525 in adults) in Scotland. Compared with the reference group of children aged 6-17 years, the risk of ARI hospitalisation was higher in children aged 3-5 years (aHR = 4.55; 95% CI: 4.11-5.04). Compared with those aged 25-29 years, the risk of ARI hospitalisation was highest among the oldest adults aged ≥80 years (aHR = 7.86; 95% CI: 7.06-8.76). Adults from more deprived areas (most deprived vs. least deprived, aHR = 1.64; 95% CI: 1.57-1.72), with existing health conditions (≥5 vs. 0 health conditions, aHR = 4.84; 95% CI: 4.53-5.18) or with history of all-cause emergency admissions (≥6 vs. 0 previous emergency admissions, aHR = 7.53; 95% CI: 5.48-10.35) were at a higher risk of ARI hospitalisations. The risk increased by the number of existing health conditions and previous emergency admission. Similar associations were seen in children.CONCLUSIONS: Younger children, older adults, those from more deprived backgrounds and individuals with greater numbers of pre-existing conditions and previous emergency admission were at increased risk for winter hospitalisations for ARI.

AB - OBJECTIVES: We undertook a national analysis to characterise and identify risk factors for acute respiratory infections (ARIs) resulting in hospitalisation during the winter period in Scotland.DESIGN: A population-based retrospective cohort analysis.SETTING: Scotland.PARTICIPANTS: The study involved 5.4 million residents in Scotland.MAIN OUTCOME MEASURES: Cox proportional hazard models were used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the association between risk factors and ARI hospitalisation.RESULTS: Between 1 September 2022 and 31 January 2023, there were 22,284 (10.9% of 203,549 with any emergency hospitalisation) ARI hospitalisations (1759 in children and 20,525 in adults) in Scotland. Compared with the reference group of children aged 6-17 years, the risk of ARI hospitalisation was higher in children aged 3-5 years (aHR = 4.55; 95% CI: 4.11-5.04). Compared with those aged 25-29 years, the risk of ARI hospitalisation was highest among the oldest adults aged ≥80 years (aHR = 7.86; 95% CI: 7.06-8.76). Adults from more deprived areas (most deprived vs. least deprived, aHR = 1.64; 95% CI: 1.57-1.72), with existing health conditions (≥5 vs. 0 health conditions, aHR = 4.84; 95% CI: 4.53-5.18) or with history of all-cause emergency admissions (≥6 vs. 0 previous emergency admissions, aHR = 7.53; 95% CI: 5.48-10.35) were at a higher risk of ARI hospitalisations. The risk increased by the number of existing health conditions and previous emergency admission. Similar associations were seen in children.CONCLUSIONS: Younger children, older adults, those from more deprived backgrounds and individuals with greater numbers of pre-existing conditions and previous emergency admission were at increased risk for winter hospitalisations for ARI.

KW - epidemiology

KW - health informatics

KW - respiratory medicine

U2 - 10.1177/01410768231223584

DO - 10.1177/01410768231223584

M3 - Article

C2 - 38345538

SN - 0141-0768

JO - Journal of the Royal Society of Medicine

JF - Journal of the Royal Society of Medicine

ER -

Risk of winter hospitalisation and death from acute respiratory infections in Scotland: national retrospective cohort study

Abstract

Bibliographical note

Keywords

Access to Document

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Cite this