摘要：Objectives. We assessed risk factors for 2009 pandemic influenza A (H1N1)–related hospitalization, mechanical ventilation, and death among New Mexico residents. Methods. We calculated population rate ratios using Poisson regression to analyze risk factors for H1N1-related hospitalization. We performed a cross-sectional analysis of hospitalizations during September 14, 2009 through January 13, 2010, using logistic regression to assess risk factors for mechanical ventilation and death among those hospitalized. Results. During the study period, 926 laboratory-confirmed H1N1-related hospitalizations were identified. H1N1-related hospitalization was significantly higher among American Indians (risk ratio [RR] = 2.6; 95% confidence interval [CI] = 2.2, 3.2), Blacks (RR = 1.7; 95% CI = 1.2, 2.4), and Hispanics (RR = 1.8; 95% CI = 1.5, 2.0) than it was among non-Hispanic Whites, and also was higher among persons of younger age and lower household income. Mechanical ventilation was significantly associated with age 25 years and older, obesity, and lack of or delayed antiviral treatment. Death was significantly associated with male gender, cancer during the previous 12 months, and liver disorder. Conclusions. This analysis supports recent national efforts to include American Indian/Alaska Native race as a group at high risk for complications of influenza with respect to vaccination and antiviral treatment recommendations. Rates of 2009 pandemic influenza A (H1N1)–related hospitalization and death in Arizona and New Mexico have been reported to be higher among American Indians/Alaska Natives (AIANs) than among non-AIAN populations. 1 An investigation in 12 states, comprising 50% of the country's AIAN population, reported that death rates among AIANs were 4 times higher than among non-AIANs. 1 Other studies have reported similar patterns of higher pandemic H1N1–related hospitalization and death among other indigenous populations compared with nonindigenous populations. 2 – 4 Health outcome differences by race/ethnicity are not fully understood but might be explained by the prevalence of underlying chronic medical conditions, access to medical care, and socioeconomic status (SES). 5 , 6 The New Mexico Department of Health (NMDOH) began conducting statewide active surveillance of pandemic H1N1–related hospitalizations and deaths in September 2009. Statewide surveillance in New Mexico includes data primarily from 3 major racial/ethnic groups: American Indians (AIs), Hispanic Whites, and non-Hispanic Whites. In New Mexico, varied socioeconomic, cultural, and geographic factors exist that might influence access to medical care and health outcomes identified through surveillance. Given that most individuals with H1N1 illness are not hospitalized, the true denominator of H1N1 disease is difficult to determine; we therefore focused on severe illness. Specifically, we conducted this analysis to assess risk factors, including race/ethnicity, for increased pandemic H1N1–related hospitalization, mechanical ventilation, and death among New Mexico residents.
