TY - JOUR
T1 - Mortality Associated with Infectious Diseases in Dutch Nursing Homes
AU - Manyam, Meghanadh
AU - Biesheuvel, Mirthe
AU - Haenen, Anja
AU - van Asten, Liselotte
AU - van Werkhoven, C. H.Henri
AU - van de Kassteele, Jan
AU - van Gageldonk-Lafeber, Rianne
AU - de Greeff, Sabine
AU - van Houten, Paul
AU - van den Bos, Marieke
AU - Roeloffzen, Petra
AU - Salomons, Hedy
AU - Debast, Sylvia
AU - Beckers, Astrid
AU - Teeuw, Alfred
AU - Hertogh, Cees
N1 - Publisher Copyright:
© 2024 Post-Acute and Long-Term Care Medical Association
PY - 2024/11
Y1 - 2024/11
N2 - Background: Although older people in nursing homes have a larger susceptibility to infectious diseases, the extent to which infectious diseases contribute to their mortality is unknown. Therefore, we quantified the associations between seasonal infectious diseases and all-cause mortality in Dutch nursing homes. Methods: We analyzed time series (January 2009 to December 2021) of the weekly sentinel surveillance of infectious diseases in Dutch nursing homes. A generalized linear model with binomial distribution and identity link was used to associate the proportion of all-cause mortality with the incidence of infections: COVID-19 (2020–2021), gastroenteritis (GE), influenza-like illness (ILI), and lower respiratory tract infections (LRTIs) at 0- to 4-week time-lags (mortality incidence at 0 to 4 weeks after infections incidence). Results: Over 13 years, 81 nursing homes participated, with 20 to 35 homes each year (mean: 26). A total of 11,555 all-cause deaths occurred over 1,864,667 resident weeks, averaging a mortality incidence of 6.2 per 1000 resident weeks. All 4 tested infectious diseases exhibited a significant association with all-cause mortality in nursing homes (P ≤ .01). Collectively, these infectious diseases were associated with 18.6% (95% CI, 17.8%–19.3%) of all deaths. The association between mortality and ILI was significant in 7 of 12 ILI seasons. Yearly mortality associated with the specific infectious diseases was as follows: LRTI (10.2%; 95% CI, 9.6%–10.8%), ILI (8.2%; 95% CI, 7.5%–8.9%) (over the 7 of 12 significant seasons), COVID-19 (6.5%; 95% CI, 5.4%–7.7%) (over 2019–2021 as there was no previous SARS-CoV-2 circulation), and GE (2.3%; 95% CI, 2.0%–2.5%). Conclusion and Implications: In nursing homes, the occurrence of seasonal respiratory and gastrointestinal infections is associated with nearly one-fifth of all-cause deaths. Although infection prevention and surveillance may already be performed in some nursing homes, it is vital to implement, and enhance targeted strategies like (hand) hygiene protocols, environmental cleaning practices, reducing droplet and aerosol transmission, and vaccination to effectively address specific infections.
AB - Background: Although older people in nursing homes have a larger susceptibility to infectious diseases, the extent to which infectious diseases contribute to their mortality is unknown. Therefore, we quantified the associations between seasonal infectious diseases and all-cause mortality in Dutch nursing homes. Methods: We analyzed time series (January 2009 to December 2021) of the weekly sentinel surveillance of infectious diseases in Dutch nursing homes. A generalized linear model with binomial distribution and identity link was used to associate the proportion of all-cause mortality with the incidence of infections: COVID-19 (2020–2021), gastroenteritis (GE), influenza-like illness (ILI), and lower respiratory tract infections (LRTIs) at 0- to 4-week time-lags (mortality incidence at 0 to 4 weeks after infections incidence). Results: Over 13 years, 81 nursing homes participated, with 20 to 35 homes each year (mean: 26). A total of 11,555 all-cause deaths occurred over 1,864,667 resident weeks, averaging a mortality incidence of 6.2 per 1000 resident weeks. All 4 tested infectious diseases exhibited a significant association with all-cause mortality in nursing homes (P ≤ .01). Collectively, these infectious diseases were associated with 18.6% (95% CI, 17.8%–19.3%) of all deaths. The association between mortality and ILI was significant in 7 of 12 ILI seasons. Yearly mortality associated with the specific infectious diseases was as follows: LRTI (10.2%; 95% CI, 9.6%–10.8%), ILI (8.2%; 95% CI, 7.5%–8.9%) (over the 7 of 12 significant seasons), COVID-19 (6.5%; 95% CI, 5.4%–7.7%) (over 2019–2021 as there was no previous SARS-CoV-2 circulation), and GE (2.3%; 95% CI, 2.0%–2.5%). Conclusion and Implications: In nursing homes, the occurrence of seasonal respiratory and gastrointestinal infections is associated with nearly one-fifth of all-cause deaths. Although infection prevention and surveillance may already be performed in some nursing homes, it is vital to implement, and enhance targeted strategies like (hand) hygiene protocols, environmental cleaning practices, reducing droplet and aerosol transmission, and vaccination to effectively address specific infections.
KW - Elderly
KW - infectious diseases
KW - mortality
KW - nursing homes
KW - surveillance
KW - time series analysis
UR - http://www.scopus.com/inward/record.url?scp=85206195443&partnerID=8YFLogxK
U2 - 10.1016/j.jamda.2024.105198
DO - 10.1016/j.jamda.2024.105198
M3 - Article
C2 - 39147369
AN - SCOPUS:85206195443
SN - 1525-8610
VL - 25
SP - 1
EP - 11
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 11
M1 - 105198
ER -