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Modelling Estimates of Norovirus Disease in Patients with Chronic Medical Conditions.
PLoS One. 2016; 11(7):e0158822.Plos

Abstract

BACKGROUND

The burden of disease due to norovirus infection has been well described in the general United States population, but studies of norovirus occurrence among persons with chronic medical conditions have been limited mostly to the immunocompromised. We assessed the impact of norovirus gastroenteritis on health care utilization in US subjects with a range of chronic medical conditions.

METHODS

We performed a retrospective cohort study using MarketScan data from July 2002 to December 2013, comparing the rates of emergency department visits, outpatient visits and hospitalizations among patients with chronic conditions (renal, cardiovascular, respiratory, immunocompromising, gastrointestinal, hepatic/pancreatic and neurological conditions and diabetes) with those in a healthy population. We estimated the rates of these outcomes due to norovirus gastroenteritis using an indirect modelling approach whereby cases of gastroenteritis of unknown cause and not attributed to a range of other causes were assumed to be due to norovirus.

RESULTS

Hospitalization rates for norovirus gastroenteritis were higher in all of the risk groups analyzed compared with data in otherwise healthy subjects, ranging from 3.2 per 10,000 person-years in persons with chronic respiratory conditions, to 23.1 per 10,000 person-years in persons with chronic renal conditions, compared to 2.1 per 10,000 among persons without chronic conditions. Over 51% of all norovirus hospitalizations occurred in the 37% of the population with some form of chronic medical condition. Outpatient visits for norovirus gastroenteritis were also increased in persons with chronic gastrointestinal or immunocompromising conditions.

CONCLUSION

Norovirus gastroenteritis leads to significantly higher rates of healthcare utilization in patients with a chronic medical condition compared to patients without any such condition.

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Authors+Show Affiliations

Verstraeten T
P95 Pharmacovigilance and Epidemiology Services, Leuven, Belgium.
Jiang B
Takeda Development Center Americas, Inc., Deerfield, Illinois, United States of America.
Weil JG
Takeda Pharmaceuticals International, Zurich, Switzerland.
Lin JH
Takeda Development Center Americas, Inc., Deerfield, Illinois, United States of America.

MeSH

Acute DiseaseAdolescentAdultAge FactorsAgedAged, 80 and overCaliciviridae InfectionsChildChild, PreschoolChronic DiseaseDelivery of Health CareEmergency Service, HospitalGastroenteritisHospitalizationHumansIncidenceInfantInfant, NewbornMiddle AgedModels, StatisticalNorovirusOutpatientsRisk FactorsSeasonsYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27438335

Citation

Verstraeten, Thomas, et al. "Modelling Estimates of Norovirus Disease in Patients With Chronic Medical Conditions." PloS One, vol. 11, no. 7, 2016, pp. e0158822.
Verstraeten T, Jiang B, Weil JG, et al. Modelling Estimates of Norovirus Disease in Patients with Chronic Medical Conditions. PLoS One. 2016;11(7):e0158822.
Verstraeten, T., Jiang, B., Weil, J. G., & Lin, J. H. (2016). Modelling Estimates of Norovirus Disease in Patients with Chronic Medical Conditions. PloS One, 11(7), e0158822. https://doi.org/10.1371/journal.pone.0158822
Verstraeten T, et al. Modelling Estimates of Norovirus Disease in Patients With Chronic Medical Conditions. PLoS One. 2016;11(7):e0158822. PubMed PMID: 27438335.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modelling Estimates of Norovirus Disease in Patients with Chronic Medical Conditions. AU - Verstraeten,Thomas, AU - Jiang,Baoguo, AU - Weil,John G, AU - Lin,Jennifer H, Y1 - 2016/07/20/ PY - 2015/08/14/received PY - 2016/06/22/accepted PY - 2016/7/21/entrez PY - 2016/7/22/pubmed PY - 2017/8/2/medline SP - e0158822 EP - e0158822 JF - PloS one JO - PLoS One VL - 11 IS - 7 N2 - BACKGROUND: The burden of disease due to norovirus infection has been well described in the general United States population, but studies of norovirus occurrence among persons with chronic medical conditions have been limited mostly to the immunocompromised. We assessed the impact of norovirus gastroenteritis on health care utilization in US subjects with a range of chronic medical conditions. METHODS: We performed a retrospective cohort study using MarketScan data from July 2002 to December 2013, comparing the rates of emergency department visits, outpatient visits and hospitalizations among patients with chronic conditions (renal, cardiovascular, respiratory, immunocompromising, gastrointestinal, hepatic/pancreatic and neurological conditions and diabetes) with those in a healthy population. We estimated the rates of these outcomes due to norovirus gastroenteritis using an indirect modelling approach whereby cases of gastroenteritis of unknown cause and not attributed to a range of other causes were assumed to be due to norovirus. RESULTS: Hospitalization rates for norovirus gastroenteritis were higher in all of the risk groups analyzed compared with data in otherwise healthy subjects, ranging from 3.2 per 10,000 person-years in persons with chronic respiratory conditions, to 23.1 per 10,000 person-years in persons with chronic renal conditions, compared to 2.1 per 10,000 among persons without chronic conditions. Over 51% of all norovirus hospitalizations occurred in the 37% of the population with some form of chronic medical condition. Outpatient visits for norovirus gastroenteritis were also increased in persons with chronic gastrointestinal or immunocompromising conditions. CONCLUSION: Norovirus gastroenteritis leads to significantly higher rates of healthcare utilization in patients with a chronic medical condition compared to patients without any such condition. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/27438335/Modelling_Estimates_of_Norovirus_Disease_in_Patients_with_Chronic_Medical_Conditions_ DB - PRIME DP - Unbound Medicine ER -