Hospitalizations and Mortality Associated With Norovirus Outbreaks in Nursing Homes, 2009-2010

摘要: Context Norovirus outbreaks are common among vulnerable, elderly populations in US nursing homes. Objectives To assess whether all-cause hospitalization and mortality rates increased during norovirus outbreak vs nonoutbreak periods homes, to identify factors associated with risk. Design, Setting, Participants A retrospective cohort study of Medicare-certified homes Oregon, Wisconsin, Pennsylvania that reported at least 1 confirmed or suspected the Centers for Disease Control Prevention's National Outbreak Reporting System (NORS), January 2009 December 2010. Deaths hospitalizations occurring residents these were identified through Medicare Minimum Data Set (MDS). Main Outcome Measures Rates compared estimated using a random-effects Poisson regression model controlling background seasonality both outcomes. Results The consisted 308 407 NORS. Per MDS, 67 730 26 055 deaths occurred 2-year study. Hospitalization 124.0 (95% CI, 119.4-129.1) 109.5 108.6-110.3) per home−year periods, yielding seasonally adjusted rate ratio (RR) 1.09 1.05-1.14). Similarly, 53.7 50.6-57.0) 41.9 41.4-42.4) (seasonally RR, 1.11; 95% 1.05-1.18). increases concentrated first 2 weeks (week 0 1) initial week 0) outbreak, respectively. Homes lower daily registered nurse (RN) hours resident ( Conclusion significant concurrent