• Ting Shi, Tristan Millington, Chris Robertson, Karen Jeffrey, KatikireddiSrinivasa VittalSVMRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, G12 8QQ, Scotland, UK., Colin McCowan, Colin R Simpson, Lana Woolford, Luke Daines, Steven Kerr, Ben Swallow, Adeniyi Fagbamigbe, Catalina A Vallejos, David Weatherill, Sandra Jayacodi, Kimberly Marsh, Jim McMenamin, Igor Rudan, Lewis Duthie Ritchie, Tanja Mueller, Amanj Kurdi, Aziz Sheikh, and Public Health Scotland and the EAVE II Collaborators.
• Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, EH8 9AG, Scotland, UK.
• J R Soc Med. 2024 Jul 1; 117 (7): 232246232-246.

ObjectivesWe undertook a national analysis to characterise and identify risk factors for acute respiratory infections (ARIs) resulting in hospitalisation during the winter period in Scotland.DesignA population-based retrospective cohort analysis.SettingScotland.ParticipantsThe study involved 5.4 million residents in Scotland.Main Outcome MeasuresCox proportional hazard models were used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the association between risk factors and ARI hospitalisation.ResultsBetween 1 September 2022 and 31 January 2023, there were 22,284 (10.9% of 203,549 with any emergency hospitalisation) ARI hospitalisations (1759 in children and 20,525 in adults) in Scotland. Compared with the reference group of children aged 6-17 years, the risk of ARI hospitalisation was higher in children aged 3-5 years (aHR = 4.55; 95% CI: 4.11-5.04). Compared with those aged 25-29 years, the risk of ARI hospitalisation was highest among the oldest adults aged ≥80 years (aHR = 7.86; 95% CI: 7.06-8.76). Adults from more deprived areas (most deprived vs. least deprived, aHR = 1.64; 95% CI: 1.57-1.72), with existing health conditions (≥5 vs. 0 health conditions, aHR = 4.84; 95% CI: 4.53-5.18) or with history of all-cause emergency admissions (≥6 vs. 0 previous emergency admissions, aHR = 7.53; 95% CI: 5.48-10.35) were at a higher risk of ARI hospitalisations. The risk increased by the number of existing health conditions and previous emergency admission. Similar associations were seen in children.ConclusionsYounger children, older adults, those from more deprived backgrounds and individuals with greater numbers of pre-existing conditions and previous emergency admission were at increased risk for winter hospitalisations for ARI.

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