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Influenza virus and factors that are associated with ICU admission, pulmonary co-infections and ICU mortality

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  • Influenza virus and factors that are associated with ICU admission, pulmonary co-infections and ICU mortality

    J Crit Care. 2018 Nov 15;50:59-65. doi: 10.1016/j.jcrc.2018.11.013. [Epub ahead of print]
    Influenza virus and factors that are associated with ICU admission, pulmonary co-infections and ICU mortality.

    Beumer MC1, Koch RM2, van Beuningen D1, OudeLashof AM3, van de Veerdonk FL4, Kolwijck E5, van der Hoeven JG1, Bergmans DC6, Hoedemaekers CWE1.
    Author information

    Abstract

    PURPOSE:

    While most influenza patients have a self-limited respiratory illness, 5-10% of hospitalized patients develop severe disease requiring ICU admission. The aim of this study was to identify influenza-specific factors associated with ICU admission and mortality. Furthermore, influenza-specific pulmonary bacterial, fungal and viral co-infections were investigated.
    METHODS:

    199 influenza patients, admitted to two academic hospitals in the Netherlands between 01 and 10-2015 and 01-04-2016 were investigated of which 45/199 were admitted to the ICU.
    RESULTS:

    A history of Obstructive/Central Sleep Apnea Syndrome, myocardial infarction, dyspnea, influenza type A, BMI > 30, the development of renal failure and bacterial and fungal co-infections, were observed more frequently in patients who were admitted to the ICU, compared with patients at the normal ward. Co-infections were evident in 55.6% of ICU-admitted patients, compared with 20.1% of patients at the normal ward, mainly caused by Staphylococcus aureus, Streptococcus pneumoniae, and Aspergillus fumigatus. Non-survivors suffered from diabetes mellitus and (pre-existent) renal failure more often.
    CONCLUSIONS:

    The current study indicates that a history of OSAS/CSAS, myocardial infarction and BMI > 30 might be related to ICU admission in influenza patients. Second, ICU patients develop more pulmonary co-infections. Last, (pre-existent) renal failure and diabetes mellitus are more often observed in non-survivors.
    Copyright 2018. Published by Elsevier Inc.


    KEYWORDS:

    Bacterial; Co-infections; Fungal; ICU admission; ICU mortality; Influenza virus; Risk factors; Viral

    PMID: 30481669 DOI: 10.1016/j.jcrc.2018.11.013
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