BACKGROUND: Respiratory syncytial virus (RSV) and influenza are responsible for considerable morbidity and mortality, particularly among adults ≥60 years. This study assessed characteristics, length of stay (LOS), and costs of RSV and influenza hospitalizations in this population in the United States (US).
METHODS: A nationally representative, retrospective, cross-sectional study was conducted using the National Inpatient Sample databases from 2016 to 2019. RSV and influenza hospitalizations for adults ≥60 years were identified using ICD-10-CM diagnosis codes. Hospitalizations with diagnoses for both RSV and influenza were excluded. Charges were converted to costs using hospital-specific cost-to-charge ratios and are presented in 2021 US dollars.
RESULTS: A total of 108,175 RSV hospitalizations (primary diagnosis, 20.6%) and 664,675 influenza hospitalizations (primary diagnosis, 46.9%) were reported from 2016 to 2019. Pulmonary, metabolic, and cardiac conditions were the most common co-occurring conditions (Table). Females accounted for 60.2% of RSV and 55.5% of influenza hospitalizations. Mechanical ventilator use was observed in 7.3% of RSV and 6.4% of influenza hospitalizations. The mean (standard deviation [SD]) LOS and cost of RSV hospitalizations were 6.6 (7.6) days and $18,250 ($28,178), respectively. Similarly, the mean (SD) LOS and cost of influenza hospitalization were 5.6 (6.5) days and $14,265 ($22,503), respectively.
CONCLUSIONS: RSV hospitalizations tended to be longer, more expensive, and associated more with other pulmonary conditions than influenza hospitalizations among adults ≥60 years. Mechanical ventilator utilization and death were reported marginally more for RSV hospitalizations. Future RSV prevention strategies, including vaccination, should be considered given RSV’s burden of illness.
