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A Prediction Rule to Identify Severe Cases among Adult Patients Hospitalized with Pandemic Influenza A (H1N1) 2009

tetano

Editor, Senior Moderator
J Korean Med Sci. 2011 Apr;26(4):499-506. Epub 2011 Mar 28.
A Prediction Rule to Identify Severe Cases among Adult Patients Hospitalized with Pandemic Influenza A (H1N1) 2009.

Oh WS, Lee SJ, Lee CS, Hur JA, Hur AC, Park YS, Heo ST, Bae IG, Park SW, Kim ES, Kim HB, Song KH, Lee KS, Lee SR, Yeom JS, Lee SJ, Kim BN, Kwak YG, Lee JH, Kim YK, Kim HY, Kim NJ, Oh MD.

Department of Internal Medicine, Kangwon National University School of Medicine, Chucheon, Korea.
Abstract

The purpose of this study was to establish a prediction rule for severe illness in adult patients hospitalized with pandemic influenza A (H1N1) 2009. At the time of initial presentation, the baseline characteristics of those with severe illness (i.e., admission to intensive care unit, mechanical ventilation, or death) were compared to those of patients with non-severe illnesses. A total of 709 adults hospitalized with pandemic influenza A (H1N1) 2009 were included: 75 severe and 634 non-severe cases. The multivariate analysis demonstrated that altered mental status, hypoxia (PaO(2)/FiO(2) ≤ 250), bilateral lung infiltration, and old age (≥ 65 yr) were independent risk factors for severe cases (all P < 0.001). The area under the ROC curve (0.834 [95% CI, 0.778-0.890]) of the number of risk factors were not significantly different with that of APACHE II score (0.840 [95% CI, 0.790-0.891]) (P = 0.496). The presence of ≥ 2 risk factors had a higher sensitivity, specificity, positive predictive value and negative predictive value than an APACHE II score of ≥ 13. As a prediction rule, the presence of ≥ 2 these risk factors is a powerful and easy-to-use predictor of the severity in adult patients hospitalized with pandemic influenza A (H1N1) 2009.

PMID: 21468256 [PubMed - in process]Free PMC Article

http://www.ncbi.nlm.nih.gov/pubmed/21468256
 
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