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Infect Control Hosp Epidemiol. 2015 Jul 30:1-10. [Epub ahead of print]
Severe Influenza in 33 US Hospitals, 2013-2014: Complications and Risk Factors for Death in 507 Patients.
Shah NS1, Greenberg JA1, McNulty MC1, Gregg KS2, Riddell J2, Mangino JE3, Weber DM3, Hebert CL3, Marzec NS4, Barron MA4, Chaparro-Rojas F5, Restrepo A6, Hemmige V6, Prasidthrathsint K7, Cobb S7, Herwaldt L7, Raabe V8, Cannavino CR8, Hines AG9, Bares SH9, Antiporta PB10, Scardina T11, Patel U12, Reid G10, Mohazabnia P13, Kachhdiya S13, Le BM13, Park CJ14, Ostrowsky B14, Robicsek A1, Smith BA15, Schied J16, Bhatti MM16, Mayer S17, Sikka M17, Murphy-Aguilu I17, Patwari P18, Abeles SR19, Torriani FJ19, Abbas Z20, Toya S20, Doktor K21, Chakrabarti A21, Doblecki-Lewis S21, Looney DJ22, David MZ1.
Author information
Abstract
BACKGROUND Influenza A (H1N1) pdm09 became the predominant circulating strain in the United States during the 2013-2014 influenza season. Little is known about the epidemiology of severe influenza during this season. METHODS A retrospective cohort study of severely ill patients with influenza infection in intensive care units in 33 US hospitals from September 1, 2013, through April 1, 2014, was conducted to determine risk factors for mortality present on intensive care unit admission and to describe patient characteristics, spectrum of disease, management, and outcomes. RESULTS A total of 444 adults and 63 children were admitted to an intensive care unit in a study hospital; 93 adults (20.9%) and 4 children (6.3%) died. By logistic regression analysis, the following factors were significantly associated with mortality among adult patients: older age (>65 years, odds ratio, 3.1 [95% CI, 1.4-6.9], P=.006 and 50-64 years, 2.5 [1.3-4.9], P=.007; reference age 18-49 years), male sex (1.9 [1.1-3.3], P=.031), history of malignant tumor with chemotherapy administered within the prior 6 months (12.1 [3.9-37.0], P<.001), and a higher Sequential Organ Failure Assessment score (for each increase by 1 in score, 1.3 [1.2-1.4], P<.001). CONCLUSION Risk factors for death among US patients with severe influenza during the 2013-2014 season, when influenza A (H1N1) pdm09 was the predominant circulating strain type, shifted in the first postpandemic season in which it predominated toward those of a more typical epidemic influenza season. Infect. Control Hosp. Epidemiol. 2015;00(0):1-10.
PMID: 26224364 [PubMed - as supplied by publisher]
Severe Influenza in 33 US Hospitals, 2013-2014: Complications and Risk Factors for Death in 507 Patients.
Shah NS1, Greenberg JA1, McNulty MC1, Gregg KS2, Riddell J2, Mangino JE3, Weber DM3, Hebert CL3, Marzec NS4, Barron MA4, Chaparro-Rojas F5, Restrepo A6, Hemmige V6, Prasidthrathsint K7, Cobb S7, Herwaldt L7, Raabe V8, Cannavino CR8, Hines AG9, Bares SH9, Antiporta PB10, Scardina T11, Patel U12, Reid G10, Mohazabnia P13, Kachhdiya S13, Le BM13, Park CJ14, Ostrowsky B14, Robicsek A1, Smith BA15, Schied J16, Bhatti MM16, Mayer S17, Sikka M17, Murphy-Aguilu I17, Patwari P18, Abeles SR19, Torriani FJ19, Abbas Z20, Toya S20, Doktor K21, Chakrabarti A21, Doblecki-Lewis S21, Looney DJ22, David MZ1.
Author information
Abstract
BACKGROUND Influenza A (H1N1) pdm09 became the predominant circulating strain in the United States during the 2013-2014 influenza season. Little is known about the epidemiology of severe influenza during this season. METHODS A retrospective cohort study of severely ill patients with influenza infection in intensive care units in 33 US hospitals from September 1, 2013, through April 1, 2014, was conducted to determine risk factors for mortality present on intensive care unit admission and to describe patient characteristics, spectrum of disease, management, and outcomes. RESULTS A total of 444 adults and 63 children were admitted to an intensive care unit in a study hospital; 93 adults (20.9%) and 4 children (6.3%) died. By logistic regression analysis, the following factors were significantly associated with mortality among adult patients: older age (>65 years, odds ratio, 3.1 [95% CI, 1.4-6.9], P=.006 and 50-64 years, 2.5 [1.3-4.9], P=.007; reference age 18-49 years), male sex (1.9 [1.1-3.3], P=.031), history of malignant tumor with chemotherapy administered within the prior 6 months (12.1 [3.9-37.0], P<.001), and a higher Sequential Organ Failure Assessment score (for each increase by 1 in score, 1.3 [1.2-1.4], P<.001). CONCLUSION Risk factors for death among US patients with severe influenza during the 2013-2014 season, when influenza A (H1N1) pdm09 was the predominant circulating strain type, shifted in the first postpandemic season in which it predominated toward those of a more typical epidemic influenza season. Infect. Control Hosp. Epidemiol. 2015;00(0):1-10.
PMID: 26224364 [PubMed - as supplied by publisher]