Hospitalized adult patients with 2009 influenza A(H1N1) in Beijing, China: risk factors for hospital mortality

BMC Infectious Diseases

Research Article

Jie Duan¹  Ang Li²  Li Jiang³  Xiuming Xi³  Yuan Xu⁴  Bin Du⁵ 

[1] Beijing Bureau of Health, Block B, 70 Zao Lin Qian Jie, 100053, Beijing, China;Department of Critical Care Medicine, Beijing Friendship Hospital, Capital University of Medical Sciences, 95 Yong An Lu, 100050, Beijing, China;Department of Critical Care Medicine, Beijing Fuxing Hospital, Capital University of Medical Sciences, 20A Fu Xing Men Wai Da Jie, 100038, Beijing, China;Department of Critical Care Medicine, Beijing Tongren Hospital, Capital University of Medical Sciences, 1 Dong Jiao Min Xiang, 100730, Beijing, China;Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College, 1 Shuai Fu Yuan, 100730, Beijing, China;

关键词: Influenza;    Septic Shock;    Hospital Mortality;    Intensive Care Unit Admission;    Severe Acute Respiratory Syndrome;   

DOI  :  10.1186/1471-2334-10-256

 received in 2010-07-14, accepted in 2010-08-27,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundIn April 2009, the pandemic influenza A(H1N1) virus emerged and spread globally. The objective of this study was to describe the independent risk factors for hospital mortality and the treatment effect of corticosteroids among patients with 2009 influenza A(H1N1) infection.MethodsWe retrospectively obtained clinical data of 155 adult patients with confirmed infection of 2009 influenza A(H1N1) in 23 hospitals in Beijing, China from October 1 to December 23, 2009. Risk factors for hospital mortality were identified with multivariate logistic regression analysis.ResultsAmong the 155 patients, 90 (58.1%) were male, and mean age was 43.0 ± 18.6 years, and comorbidities were present in 81 (52.3%) patients. The most common organ dysfunctions included acute respiratory failure, altered mental status, septic shock, and acute renal failure. Oseltamivir was initiated in 125 patients (80.6%), only 16 patients received antiviral therapy within 48 hours after symptom onset. Fifty-two patients (33.5%) were treated with systemic corticosteroids, with a median daily dose of 80 mg. Twenty-seven patients (17.4%) died during hospital stay. Diabetes [odds ratio (OR) 8.830, 95% confidence interval [CI] 2.041 to 38.201, p = 0.004) and lactate dehydrogenase (LDH) level (OR 1.240, 95% CI 1.025 to 1.500, p = 0.027) were independent risk factors of hospital death, as were septic shock and altered mental status. Corticosteroids use was associated with a trend toward higher hospital mortality (OR 3.668, 95% CI 0.987 to 13.640, p = 0.052).ConclusionsHospitalized patients with 2009 H1N1 influenza had relative poor outcome. The risk factors at hospitalization may help clinicians to identify the high-risk patients. In addition, corticosteroids use should not be regarded as routine pharmacologic therapy.

【 授权许可】

Unknown   
© Xi et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.