TY - JOUR
T1 - Outcome of critically ill patients with influenza virus infection
AU - Li, Guangxi
AU - Yilmaz, Murat
AU - Kojicic, Marija
AU - Fernández-Pérez, Evans
AU - Wahab, Raed
AU - Huskins, W. Charles
AU - Afessa, Bekele
AU - Truwit, Jonathon D.
AU - Gajic, Ognjen
PY - 2009/11
Y1 - 2009/11
N2 - Background: Influenza is a major cause of morbidity and mortality, with its greatest burden on the elderly and patients with chronic co-morbidities in the intensive care unit (ICU). An accurate prognosis is essential for decision-making during pandemic as well as interpandemic periods. Methods: A retrospective cohort study was conducted to determine prognostic factors influencing short term outcome of critically ill patients with confirmed influenza virus infection. Baseline characteristics, laboratory and diagnostic findings, ICU interventions and complications were abstracted from medical records using standard definitions and compared between hospital survivors and non-survivors with univariate and multivariate logistic regression analyses. Results: 111 patients met the inclusion criteria. Acute respiratory distress syndrome (ARDS) complicated ICU course in 25 (23%) of the patients, with mortality rate of 52%. Multivariate logistic regression analysis identified the following predictors of hospital mortality: Acute Physiology and Chronic Health Evaluation (APACHE) III predicted mortality (Odds ratio [OR] 1.49, 95% confidence interval [CI] 1.1-2.1 for 10% increase), ARDS (OR 7.7, 95% CI 2.3-29) and history of immunosuppression (OR 7.19, 95% CI 1.9-28). Conclusions: APACHE III predicted mortality, the development of ARDS and the history of immunosuppression are independent risk factors for hospital mortality in critically ill patients with confirmed influenza virus infection.
AB - Background: Influenza is a major cause of morbidity and mortality, with its greatest burden on the elderly and patients with chronic co-morbidities in the intensive care unit (ICU). An accurate prognosis is essential for decision-making during pandemic as well as interpandemic periods. Methods: A retrospective cohort study was conducted to determine prognostic factors influencing short term outcome of critically ill patients with confirmed influenza virus infection. Baseline characteristics, laboratory and diagnostic findings, ICU interventions and complications were abstracted from medical records using standard definitions and compared between hospital survivors and non-survivors with univariate and multivariate logistic regression analyses. Results: 111 patients met the inclusion criteria. Acute respiratory distress syndrome (ARDS) complicated ICU course in 25 (23%) of the patients, with mortality rate of 52%. Multivariate logistic regression analysis identified the following predictors of hospital mortality: Acute Physiology and Chronic Health Evaluation (APACHE) III predicted mortality (Odds ratio [OR] 1.49, 95% confidence interval [CI] 1.1-2.1 for 10% increase), ARDS (OR 7.7, 95% CI 2.3-29) and history of immunosuppression (OR 7.19, 95% CI 1.9-28). Conclusions: APACHE III predicted mortality, the development of ARDS and the history of immunosuppression are independent risk factors for hospital mortality in critically ill patients with confirmed influenza virus infection.
KW - Human
KW - ICUs
KW - Influenza
KW - Outcome Assessment
KW - Prognosis
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U2 - 10.1016/j.jcv.2009.07.015
DO - 10.1016/j.jcv.2009.07.015
M3 - Article
C2 - 19699141
AN - SCOPUS:70449686328
VL - 46
SP - 275
EP - 278
JO - Journal of Clinical Virology
JF - Journal of Clinical Virology
SN - 1386-6532
IS - 3
ER -