tetano
Editor, Senior Moderator
Infection
. 2020 Oct 22.
doi: 10.1007/s15010-020-01537-x. Online ahead of print.
Gender differences and influenza-associated mortality in hospitalized influenza A patients during the 2018/19 season
Mario Karolyi[SUP] 1 [/SUP], E Pawelka[SUP] 2 [/SUP], H Kelani[SUP] 3 [/SUP], G C Funk[SUP] 4 [/SUP], B Lindner[SUP] 5 [/SUP], C Porpaczy[SUP] 5 [/SUP], S Publig[SUP] 4 [/SUP], T Seitz[SUP] 2 [/SUP], M Traugott[SUP] 2 [/SUP], M Unterweger[SUP] 6 [/SUP], A Zoufaly[SUP] 2 [/SUP], C Wenisch[SUP] 2 [/SUP]
Affiliations
Abstract
Background: In this study we analyzed gender differences in the clinical presentation of patients with molecular confirmed influenza A. Additionally, we tried to identify predictors of influenza-associated mortality.
Materials/methods: In this prospective observational multi-center-study we included all influenza-positive patients ≥ 18 years who were hospitalized and treated on flu-isolation-wards in three hospitals in Vienna during the 2018/19 influenza season. Diagnoses were made via Cobas[SUP]?[/SUP] Liat[SUP]?[/SUP] POCT.
Results: 490 Patients (48.8% female) tested positive for influenza A. Female patients were older (median age 76 years vs. 70 years, p < 0.001). Male patients had a higher rate of chronic liver disease in history (8.8% vs. 2.9%, p = 0.006), myositis (11.7% vs. 3.1%, p < 0.001) and ICU admissions (9.6% vs. 4.6%, p = 0.03). The in-hospital mortality rate was 4.3% and increased to 9.5% during the 90-day follow-up period. Female patients > 75 years had a significantly higher in-hospital mortality rate than ≤ 75-year-old females (9.2% vs. 1.7%, p = 0.019). This effect was not observed in male patients (5.4% vs. 1.9%, p = ns). Age > 75 years (OR 5.49, 95% CI 1.10-27.43), acute heart failure (OR 3.56, 95% CI 1.03-12.05) and ICU admission (OR 6.1, 95% CI 0.98-37.91) were predictors for in-hospital mortality for female patients, while any malignancy (OR 9.4, 95% CI 1.90-46.54) and ICU admission (OR 7.05, 95% CI 1.44-34.55) were predictors in male patients.
Conclusions: Gender is associated with differences in clinical presentation and complications of influenza A virus infection. Women with acute heart failure or aged > 75 years have an increased risk of influenza associated in-hospital mortality, while ICU admission and any malignancy are predictors for male patients. Mortality rates in patients > 75 years are 5-10 times higher compared to their non-hospitalized influenza-negative Austrian counterparts.
Keywords: 90-Day mortality; Flu; Gender differences; Influenza; Mortality; Predictors.
. 2020 Oct 22.
doi: 10.1007/s15010-020-01537-x. Online ahead of print.
Gender differences and influenza-associated mortality in hospitalized influenza A patients during the 2018/19 season
Mario Karolyi[SUP] 1 [/SUP], E Pawelka[SUP] 2 [/SUP], H Kelani[SUP] 3 [/SUP], G C Funk[SUP] 4 [/SUP], B Lindner[SUP] 5 [/SUP], C Porpaczy[SUP] 5 [/SUP], S Publig[SUP] 4 [/SUP], T Seitz[SUP] 2 [/SUP], M Traugott[SUP] 2 [/SUP], M Unterweger[SUP] 6 [/SUP], A Zoufaly[SUP] 2 [/SUP], C Wenisch[SUP] 2 [/SUP]
Affiliations
- PMID: 33090329
- DOI: 10.1007/s15010-020-01537-x
Abstract
Background: In this study we analyzed gender differences in the clinical presentation of patients with molecular confirmed influenza A. Additionally, we tried to identify predictors of influenza-associated mortality.
Materials/methods: In this prospective observational multi-center-study we included all influenza-positive patients ≥ 18 years who were hospitalized and treated on flu-isolation-wards in three hospitals in Vienna during the 2018/19 influenza season. Diagnoses were made via Cobas[SUP]?[/SUP] Liat[SUP]?[/SUP] POCT.
Results: 490 Patients (48.8% female) tested positive for influenza A. Female patients were older (median age 76 years vs. 70 years, p < 0.001). Male patients had a higher rate of chronic liver disease in history (8.8% vs. 2.9%, p = 0.006), myositis (11.7% vs. 3.1%, p < 0.001) and ICU admissions (9.6% vs. 4.6%, p = 0.03). The in-hospital mortality rate was 4.3% and increased to 9.5% during the 90-day follow-up period. Female patients > 75 years had a significantly higher in-hospital mortality rate than ≤ 75-year-old females (9.2% vs. 1.7%, p = 0.019). This effect was not observed in male patients (5.4% vs. 1.9%, p = ns). Age > 75 years (OR 5.49, 95% CI 1.10-27.43), acute heart failure (OR 3.56, 95% CI 1.03-12.05) and ICU admission (OR 6.1, 95% CI 0.98-37.91) were predictors for in-hospital mortality for female patients, while any malignancy (OR 9.4, 95% CI 1.90-46.54) and ICU admission (OR 7.05, 95% CI 1.44-34.55) were predictors in male patients.
Conclusions: Gender is associated with differences in clinical presentation and complications of influenza A virus infection. Women with acute heart failure or aged > 75 years have an increased risk of influenza associated in-hospital mortality, while ICU admission and any malignancy are predictors for male patients. Mortality rates in patients > 75 years are 5-10 times higher compared to their non-hospitalized influenza-negative Austrian counterparts.
Keywords: 90-Day mortality; Flu; Gender differences; Influenza; Mortality; Predictors.