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Mortality Associated with Infectious Diseases in Dutch Nursing Homes.

Meghanadh Manyam1, Mirthe Biesheuvel1, Anja Haenen1

  • 1Centre for Infectious Diseases, Epidemiology and Surveillance, Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.

Journal of the American Medical Directors Association
|August 15, 2024
PubMed
Summary

Seasonal infectious diseases like influenza-like illness and COVID-19 significantly contribute to nearly one-fifth of all-cause deaths in nursing homes. Targeted infection prevention strategies are vital to reduce mortality in this vulnerable population.

Keywords:
Elderlyinfectious diseasesmortalitynursing homessurveillancetime series analysis

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Area of Science:

  • Gerontology
  • Infectious Diseases
  • Public Health

Background:

  • Nursing home residents have increased susceptibility to infectious diseases.
  • The specific contribution of these infections to mortality in this setting was previously unquantified.

Purpose of the Study:

  • To quantify the association between seasonal infectious diseases and all-cause mortality in Dutch nursing homes.

Main Methods:

  • Analysis of time series data (2009-2021) from sentinel surveillance of infectious diseases in Dutch nursing homes.
  • Generalized linear models used to associate all-cause mortality with incidence of COVID-19, gastroenteritis (GE), influenza-like illness (ILI), and lower respiratory tract infections (LRTIs) at 0-4 week lags.

Main Results:

  • Over 13 years, 11,555 deaths occurred across 81 participating nursing homes.
  • All four tested infectious diseases were significantly associated with all-cause mortality (P ≤ .01).
  • Collectively, these infections accounted for 18.6% of all deaths, with LRTI (10.2%), ILI (8.2%), COVID-19 (6.5%), and GE (2.3%) contributing annually.

Conclusions:

  • Seasonal respiratory and gastrointestinal infections are linked to approximately 18.6% of all-cause deaths in nursing homes.
  • Enhancing targeted infection prevention strategies, including hygiene, environmental cleaning, transmission reduction, and vaccination, is crucial.