tetano
Editor, Senior Moderator
Critical Care 2011, 15:R286 doi:10.1186/cc10573
Published: 28 November 2011
Abstract (provisional)
Background
There is a vast amount of information published regarding the impact of 2009 pandemic influenza A (pH1N1) virus infection. However, a comparison of risk factors and outcome during the 2010-11 post-pandemic period has not been described.
Methods
A prospective, observational, multi-center study was carried out to evaluate the clinical characteristics and demographics of patients with positive RT-PCR for H1N1 admitted to 148 Spanish intensive care units (ICUs). Data were obtained from the 2009 pandemic and compared to the 2010-11 post-pandemic period.
Results
Nine hundred and ninety seven patients patients with confirmed An/H1N1 infection were included. Six hundred and forty eight patients affected by 2009 (pH1N1) virus infection and 349 patients affected by post-pandemic Influenza (H1N1)v infection period were analyzed. Patients during the post-pandemic period were older, had more chronic comorbid conditions and presented with higher severity scores (APACHE II and SOFA) on ICU admission. Patients from the post-pandemic Influenza (H1N1)v infection period received empiric antiviral treatment less frequently and with delayed administration. Mortality was significantly higher in the post-pandemic period. Multivariate analysis confirmed that haematological disease, invasive mechanical ventilation and continuous renal replacement therapy were factors independently associated with worse outcome in the two periods. HIV was the only new variable independently associated with higher ICU mortality during the post-pandemic Influenza (H1N1)v infection period.
Conclusion
Patients from the post-pandemic Influenza (H1N1)v infection period had an unexpectedly higher mortality rate and showed a trend towards affecting a more vulnerable population, in keeping with more typical seasonal viral infection.
http://ccforum.com/content/pdf/cc10573.pdf
Published: 28 November 2011
Abstract (provisional)
Background
There is a vast amount of information published regarding the impact of 2009 pandemic influenza A (pH1N1) virus infection. However, a comparison of risk factors and outcome during the 2010-11 post-pandemic period has not been described.
Methods
A prospective, observational, multi-center study was carried out to evaluate the clinical characteristics and demographics of patients with positive RT-PCR for H1N1 admitted to 148 Spanish intensive care units (ICUs). Data were obtained from the 2009 pandemic and compared to the 2010-11 post-pandemic period.
Results
Nine hundred and ninety seven patients patients with confirmed An/H1N1 infection were included. Six hundred and forty eight patients affected by 2009 (pH1N1) virus infection and 349 patients affected by post-pandemic Influenza (H1N1)v infection period were analyzed. Patients during the post-pandemic period were older, had more chronic comorbid conditions and presented with higher severity scores (APACHE II and SOFA) on ICU admission. Patients from the post-pandemic Influenza (H1N1)v infection period received empiric antiviral treatment less frequently and with delayed administration. Mortality was significantly higher in the post-pandemic period. Multivariate analysis confirmed that haematological disease, invasive mechanical ventilation and continuous renal replacement therapy were factors independently associated with worse outcome in the two periods. HIV was the only new variable independently associated with higher ICU mortality during the post-pandemic Influenza (H1N1)v infection period.
Conclusion
Patients from the post-pandemic Influenza (H1N1)v infection period had an unexpectedly higher mortality rate and showed a trend towards affecting a more vulnerable population, in keeping with more typical seasonal viral infection.
http://ccforum.com/content/pdf/cc10573.pdf