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Predictors of fatality in pandemic influenza a (H1N1) virus infection among adults
?nder Erg?n?l, Servet Alan, ?znur Ak, Fatman Sarg?n, Arzu Kant?rk, Alper G?nd?z, Derya Engin, Oral ?nc?l, Ilker Inanc Balkan, Bahadir Ceylan, Nur Benzonana, Saadet Yaz?c?, Funda ?im?ek, Nuray Uzun, Asuman ?nan, Eren Gulhan, Meral Ciblak, Kenan Midilli, Mustafa Ozyurt, Selim Badur, Serap Gencer, Ozcan Nazl?can, Serdar ?zer, Nail ?zg?ne?, Taner Y?ld?rmak, Turan Aslan, Pasa G?kta?, Nese Salto?lu, Muzaffer Fincanc?, Ali Ihsan Dokucu and Haluk Eraksoy
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BMC Infectious Diseases 2014, 14:317 doi:10.1186/1471-2334-14-317
Published: 10 June 2014
Abstract (provisional)
Background
The fatality attributed to pandemic influenza A H1N1 was not clear in the literature. We described the predictors for fatality related to pandemic influenza A H1N1 infection among hospitalized adult patients.
Methods
This is a multicenter study performed during the pandemic influenza A H1N1 [A(H1N1)pdm09] outbreak which occurred in 2009 and 2010. Analysis was performed among laboratory confirmed patients. Multivariate analysis was performed for the predictors of fatality.
Results
In the second wave of the pandemic, 848 adult patients were hospitalized because of suspected influenza, 45 out of 848 (5.3%) died, with 75% of fatalities occurring within the first 2 weeks of hospitalization. Among the 241 laboratory confirmed A(H1N1)pdm09 patients, the case fatality rate was 9%. In a multivariate logistic regression model that was performed for the fatalities within 14 days after admission, early use of neuraminidase inhibitors was found to be protective (Odds ratio: 0.17, confidence interval: 0.03-0.77, p = 0.022), nosocomial infections (OR: 5.7, CI: 1.84-18, p = 0.013), presence of malignant disease (OR: 3.8, CI: 0.66-22.01, p = 0.133) significantly increased the likelihood of fatality.
Conclusions
Early detection of the infection, allowing opportunity for the early use of neuraminidase inhibitors, was found to be important for prevention of fatality. Nosocomial bacterial infections and underlying malignant diseases increased the rate of fatality.
full article
?nder Erg?n?l, Servet Alan, ?znur Ak, Fatman Sarg?n, Arzu Kant?rk, Alper G?nd?z, Derya Engin, Oral ?nc?l, Ilker Inanc Balkan, Bahadir Ceylan, Nur Benzonana, Saadet Yaz?c?, Funda ?im?ek, Nuray Uzun, Asuman ?nan, Eren Gulhan, Meral Ciblak, Kenan Midilli, Mustafa Ozyurt, Selim Badur, Serap Gencer, Ozcan Nazl?can, Serdar ?zer, Nail ?zg?ne?, Taner Y?ld?rmak, Turan Aslan, Pasa G?kta?, Nese Salto?lu, Muzaffer Fincanc?, Ali Ihsan Dokucu and Haluk Eraksoy
Author Affiliations
For all author emails, please log on.
BMC Infectious Diseases 2014, 14:317 doi:10.1186/1471-2334-14-317
Published: 10 June 2014
Abstract (provisional)
Background
The fatality attributed to pandemic influenza A H1N1 was not clear in the literature. We described the predictors for fatality related to pandemic influenza A H1N1 infection among hospitalized adult patients.
Methods
This is a multicenter study performed during the pandemic influenza A H1N1 [A(H1N1)pdm09] outbreak which occurred in 2009 and 2010. Analysis was performed among laboratory confirmed patients. Multivariate analysis was performed for the predictors of fatality.
Results
In the second wave of the pandemic, 848 adult patients were hospitalized because of suspected influenza, 45 out of 848 (5.3%) died, with 75% of fatalities occurring within the first 2 weeks of hospitalization. Among the 241 laboratory confirmed A(H1N1)pdm09 patients, the case fatality rate was 9%. In a multivariate logistic regression model that was performed for the fatalities within 14 days after admission, early use of neuraminidase inhibitors was found to be protective (Odds ratio: 0.17, confidence interval: 0.03-0.77, p = 0.022), nosocomial infections (OR: 5.7, CI: 1.84-18, p = 0.013), presence of malignant disease (OR: 3.8, CI: 0.66-22.01, p = 0.133) significantly increased the likelihood of fatality.
Conclusions
Early detection of the infection, allowing opportunity for the early use of neuraminidase inhibitors, was found to be important for prevention of fatality. Nosocomial bacterial infections and underlying malignant diseases increased the rate of fatality.
full article
