Observational studyJournal of the American Geriatrics Society2021
Persistent Functional Decline Following Hospitalization with Influenza or Acute Respiratory Illness.
Observational study in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
51 citing papers in PubMed, 4 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- A Systematic Review of the Markers of Severity in Acute Respiratory Infections to Inform Primary Care Surveillance.Influenza and other respiratory viruses · 2025Pooled it
- Protection against influenza hospitalizations from enhanced influenza vaccines among older adults: A systematic review and network meta-analysis.Journal of the American Geriatrics Society · 2024Pooled it
- High Clinical Burden of Influenza Disease in Adults Aged ≥ 65 Years: Can We Do Better? A Systematic Literature Review.Advances in therapy · 2023Pooled it
- Costs of management of acute respiratory infections in older adults: A systematic review and meta-analysis.Journal of global health · 2022Pooled it
- Relative Effectiveness of High-Dose Versus Standard-Dose Influenza Vaccination Against Hospitalizations and Deaths According to Frailty Score: A Post Hoc Analysis of the DANFLU-1 Randomized Trial.The Journal of infectious diseases · 2026Trial
- Nurse Telephone Support for Caregivers of Older Adults at Hospital Discharge: A Randomized Clinical Trial.JAMA network open · 2024Trial
- COVID-19 does not influence functional status after ARDS therapy.Critical care (London, England) · 2023Trial
- Evaluating the cost-effectiveness of adjuvanted influenza vaccine in the older adult population in the Netherlands.Human vaccines & immunotherapeutics · 2026Article
- Influenza.Nature reviews. Disease primers · 2026Review
- Clinical and human burden of respiratory syncytial virus in older adults: a narrative review with emphasis on Italian data.Aging clinical and experimental research · 2026Review
- Article
- Human Metapneumovirus-associated Hospital Burden in Older Adults in Scotland: A Retrospective Analysis.Open forum infectious diseases · 2026Article
- Age-dependent immune landscapes affect influenza vaccine effectiveness and guide precision strategies.Frontiers in immunology · 2026Review
- The Role of the Clinical Frailty Scale in Stratifying Management of Older Adults with Acute Calculous Cholecystitis and Acute Gallstone Pancreatitis.International journal of general medicine · 2026Review
- Transitions in Functional Status and Frailty Among Post-Hospitalized COVID-19 Oldest-Old Adults: An 18-Month Follow-Up Study.Journal of clinical medicine · 2025Article
- Recent developments of vaccines for older adults: Adjuvants and beyond.Human vaccines & immunotherapeutics · 2025Review
- Incidence of Respiratory Syncytial Virus-Associated Hospitalization Among Adults in Ontario, Canada, 2017-2019.The Journal of infectious diseases · 2025Article
- [Age-associated changes of the immune system: immunosenescence and effects on vaccinations].Zeitschrift fur Gerontologie und Geriatrie · 2025Review
- Influenza vaccination in older people: a geriatrician's perspective.Aging clinical and experimental research · 2025Review
- Post-Discharge COVID-19 Symptoms Predict 1-Year Functional Decline, Falls, and Emergency Department Visits: A Cohort Study.Journal of the American Geriatrics Society · 2025Article
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 1 country.
Funding
Abstract
BACKGROUND/
objectivesInfluenza is associated with significant morbidity and mortality, particularly for older adults. Persistent functional decline following hospitalization has important impacts on older adults' wellbeing and independence, but has been under-studied in relation to influenza. We aimed to investigate persistent functional change in older adults admitted to hospital with influenza and other acute respiratory illness (ARI).
designProtective observational cohort study.
settingCanadian Immunization Research Network Serious Outcomes Surveillance Network 2011 to 2012 influenza season.
participantsA total of 925 patients aged 65 and older admitted to hospital with influenza and other ARI. MEASUREMENTS: Influenza was laboratory-confirmed. Frailty was measured using a Frailty index (FI). Functional status was measured using the Barthel index (BI); moderate persistent functional decline was defined as a clinically meaningful loss of ≥10 to <20 points on the 100-point BI. Catastrophic disability (CD) was defined as a loss of ≥20 points, equivalent to full loss of independence in two basic activities of daily living.
resultsFive hundred and nineteen (56.1%) were women; mean age was 79.4 (standard deviation=8.4) years. Three hundred and forty-six (37.4%) had laboratory-confirmed influenza. Influenza cases had lower baseline function (BI = 77.0 vs 86.9, P < .001) and higher frailty (FI = 0.23 vs 0.20, P < .001) than those with other ARI. A total of 8.4% died, 8.2% experienced persistent moderate functional decline, and 9.9% experienced CD. Higher baseline frailty was associated with increased odds of experiencing functional decline, CD, and death. The experience of functional decline and CD, and its association with frailty, was the same for influenza and other ARI.
conclusionFunctional loss in hospital is common among older adults; for some this functional loss is persistent and catastrophic. This highlights the importance of prevention and optimal management of acute declines in health, including influenza, to avoid hospitalization. In the case of influenza, for which vaccines exist, this raises the potential of vaccine preventable disability.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.