Epidemiology, complications, and cost of hospitalization in children with laboratory-confirmed influenza infection

Krow Ampofo, Per H. Gesteland, Jeffery Bender, Michelle Mills, Judy Daly, Matthew Samore, Carrie Byington, Andrew T. Pavia, Rajendu Srivastava

Research output: Contribution to journalArticlepeer-review

196 Scopus citations


BACKGROUND. Influenza causes significant morbidity among children. Previous studies used indirect case ascertainment methods with little cost data. We sought to measure the burden of laboratory-confirmed influenza from hospitalized children. METHODS. We conducted a retrospective cohort study during 3 viral seasons at Primary Children's Medical Center (Salt Lake City, UT). Children ≤18 years of age who were hospitalized with laboratory-confirmed influenza infection were included. Outcomes included hospitalization rates, complications including intensive care unit stays, mechanical ventilation, length of stay, and total hospital costs. RESULTS. A total of 325 children had hospitalizations attributable to influenza over 3 viral seasons: 28% <6 months of age, 33% between 6 and 23 months of age; and 39% >2 years of age; 37% had high-risk medical conditions. Population-based rates of hospitalization for Salt Lake County residents ranged from 6.3 to 252.7 per 100 000 children. The highest rates were in children younger than 6 months, and rates decreased with increasing age. Forty-nine (15%) children had an ICU stay; 27 required mechanical ventilation, and half of these patients were >2 years of age. Total hospital cost for the cohort was $2 million; 55% was accounted for by children >2 years of age. Length of stay and total hospital costs were significantly higher in all children >2 years of age compared with children <6 months of age and were comparable to all children 6 to 23 months of age. CONCLUSIONS. Proven influenza infection in children results in substantial hospital resource utilization and morbidity. Nationwide, the median hospital costs may total $55 million. Our data support the Advisory Committee on Immunization's recommendations to expand the use of influenza vaccine to children >2 years of age.

Original languageEnglish (US)
Pages (from-to)2409-2417
Number of pages9
Issue number6
StatePublished - Dec 2006


  • Children
  • Complications
  • Hospitalization
  • Influenza
  • Resource utilization

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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