tetano
Editor, Senior Moderator
Crit Care Med. 2020 Jan 9. doi: 10.1097/CCM.0000000000004207. [Epub ahead of print] [h=1]Association Between Cardiac Injury and Mortality in Hospitalized Patients Infected With Avian Influenza A (H7N9) Virus.[/h]
Gao C[SUP]1,[/SUP][SUP]2[/SUP], Wang Y[SUP]3[/SUP], Gu X[SUP]4,[/SUP][SUP]5[/SUP], Shen X[SUP]6[/SUP], Zhou D[SUP]7[/SUP], Zhou S[SUP]8[/SUP], Huang JA[SUP]9[/SUP], Cao B[SUP]3,[/SUP][SUP]5,[/SUP][SUP]10[/SUP], Guo Q[SUP]2[/SUP]; for the Community-Acquired Pneumonia–China Network.
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVES:[/h] To evaluate the prevalence of cardiac injury and its association with mortality in hospitalized patients infected with avian influenza A (H7N9) virus.
[h=4]DESIGN:[/h] Retrospective cohort study.
[h=4]SETTING:[/h] A total of 133 hospitals in 17 provinces, autonomous regions, and municipalities of mainland China that admitted influenza A (H7N9) virus-infected patients between January 22, 2015, and June 16, 2017.
[h=4]PATIENTS:[/h] A total of 321 patients with influenza A (H7N9) virus infection were included in the final analysis.
[h=4]INTERVENTIONS:[/h] None.
[h=4]MEASUREMENTS AND MAIN RESULTS:[/h] Demographics and clinical characteristics were collected from medical records. Cardiac injury was defined according to cardiac biomarkers, electrocardiography, or echocardiography. Among the 321 patients, 203 (63.2%) showed evidence of cardiac injury. Compared with the uninjured group, the cardiac injury group had lower PaO2/FIO2 (median, 102.0 vs 148.4 mm Hg; p < 0.001), higher Acute Physiology and Chronic Health Evaluation II score (median, 17.0 vs 11.0; p < 0.001), longer stay in the ICU (10.0 vs 9.0 d; p = 0.029), and higher proportion of in-hospital death (64.0% vs 20.3%; p < 0.001). The proportion of virus clearance until discharge or death was lower in the cardiac injury group than in the uninjured group (58.6% vs 86.4%; p < 0.001). Multivariable-adjusted Cox proportional hazards regression analysis showed that cardiac injury was associated with higher mortality (hazards ratio, 2.06; 95% CI, 1.31-3.24) during hospitalization.
[h=4]CONCLUSIONS:[/h] Cardiac injury is a frequent condition among hospitalized patients infected with influenza A (H7N9) virus, and it is associated with higher risk of mortality.
PMID: 31923027 DOI: 10.1097/CCM.0000000000004207
Gao C[SUP]1,[/SUP][SUP]2[/SUP], Wang Y[SUP]3[/SUP], Gu X[SUP]4,[/SUP][SUP]5[/SUP], Shen X[SUP]6[/SUP], Zhou D[SUP]7[/SUP], Zhou S[SUP]8[/SUP], Huang JA[SUP]9[/SUP], Cao B[SUP]3,[/SUP][SUP]5,[/SUP][SUP]10[/SUP], Guo Q[SUP]2[/SUP]; for the Community-Acquired Pneumonia–China Network.
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVES:[/h] To evaluate the prevalence of cardiac injury and its association with mortality in hospitalized patients infected with avian influenza A (H7N9) virus.
[h=4]DESIGN:[/h] Retrospective cohort study.
[h=4]SETTING:[/h] A total of 133 hospitals in 17 provinces, autonomous regions, and municipalities of mainland China that admitted influenza A (H7N9) virus-infected patients between January 22, 2015, and June 16, 2017.
[h=4]PATIENTS:[/h] A total of 321 patients with influenza A (H7N9) virus infection were included in the final analysis.
[h=4]INTERVENTIONS:[/h] None.
[h=4]MEASUREMENTS AND MAIN RESULTS:[/h] Demographics and clinical characteristics were collected from medical records. Cardiac injury was defined according to cardiac biomarkers, electrocardiography, or echocardiography. Among the 321 patients, 203 (63.2%) showed evidence of cardiac injury. Compared with the uninjured group, the cardiac injury group had lower PaO2/FIO2 (median, 102.0 vs 148.4 mm Hg; p < 0.001), higher Acute Physiology and Chronic Health Evaluation II score (median, 17.0 vs 11.0; p < 0.001), longer stay in the ICU (10.0 vs 9.0 d; p = 0.029), and higher proportion of in-hospital death (64.0% vs 20.3%; p < 0.001). The proportion of virus clearance until discharge or death was lower in the cardiac injury group than in the uninjured group (58.6% vs 86.4%; p < 0.001). Multivariable-adjusted Cox proportional hazards regression analysis showed that cardiac injury was associated with higher mortality (hazards ratio, 2.06; 95% CI, 1.31-3.24) during hospitalization.
[h=4]CONCLUSIONS:[/h] Cardiac injury is a frequent condition among hospitalized patients infected with influenza A (H7N9) virus, and it is associated with higher risk of mortality.
PMID: 31923027 DOI: 10.1097/CCM.0000000000004207