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THE MORBIDITY AND MORTALITY OF INFLUENZA PATIENTS TREATED AT RAMBAM MEDICAL CENTER INTENSIVE CARE UNIT IN THE YEARS 2009-2014

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  • THE MORBIDITY AND MORTALITY OF INFLUENZA PATIENTS TREATED AT RAMBAM MEDICAL CENTER INTENSIVE CARE UNIT IN THE YEARS 2009-2014

    Harefuah. 2017 Sep;156(9):559-563.
    [THE MORBIDITY AND MORTALITY OF INFLUENZA PATIENTS TREATED AT RAMBAM MEDICAL CENTER INTENSIVE CARE UNIT IN THE YEARS 2009-2014].

    [Article in Hebrew]
    Bar-Lavie Y1, Hussein K2, Mayo A1, King D1, Kra-Oz Z3, Paul M2.
    Author information

    Abstract

    INTRODUCTION:

    Data regarding the characteristics and results of the treatment of patients hospitalized in intensive care units (ICUs) with influenza in Israel are limited.
    AIMS:

    We evaluated the characteristics and outcomes of patients treated at Rambam Medical Center at the adult department of critical care medicine for influenza between the years 2009-2014.
    METHODS:

    A retrospective cohort study was conducted. Patients were detected by laboratory reports and data were extracted from electronic medical records.
    RESULTS:

    The study included 64 patients with laboratory-proven influenza. Median age was 54 years (range 17-83) and symptom duration before admission was 5 days (1-14). The median APACHE-II score at admission was 31.5 and 63.5% were in hemodynamic shock mandating the use of vasopressors. All patients received mechanical ventilation. Inhalation of nitric oxide was needed in a third; 14.3% needed Intra-Pulmonary Percussive Ventilation and steroids were given to 57.1%. ICU mortality was 24/64 (37.5%). Factors significantly associated with mortality were older age, longer length of disease prior to ICU admission, APACHE-II score, septic shock and creatinine. Mortality during the last season was lower than observed during the 2009 pandemia despite increasing severity of illness.
    CONCLUSIONS:

    The appearance of a new strain of influenza leads to high morbidity, complications and mortality due to low population immunity. There are no randomized controlled trials evaluating the efficacy of anti-viral drugs and other treatments in severe Influenza with complications.
    DISCUSSION:

    The treatment of critically-ill patients with severe influenza is complex, mandates advanced techniques of mechanical ventilation and hemodynamic support. Under intense supportive care most patients with influenza survive.


    PMID: 28971652
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