tetano
Editor, Senior Moderator
Int J Infect Dis. 2015 Sep 13. pii: S1201-9712(15)00218-0. doi: 10.1016/j.ijid.2015.09.008. [Epub ahead of print]
[h=1]Retrospective study of risk factors of mortality in human avian influenza A(H7N9) cases in Zhejiang Province, China, March 2013 to June 2014.[/h] Cheng QL[SUP]1[/SUP], Ding H[SUP]2[/SUP], Sun Z[SUP]2[/SUP], Kao QJ[SUP]2[/SUP], Yang XH[SUP]2[/SUP], Huang RJ[SUP]2[/SUP], Wen YY[SUP]2[/SUP], Wang J[SUP]2[/SUP], Xie L[SUP]3[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] The H7N9 virus is a serious disease that threatens human health. Fatalities associated with human infections caused by this disease are of great public health concerns; however, the possible risk factors are not yet fully known.
[h=4]METHODS:[/h] A stratified sampling method, incorporating household income levels and a random number table method, was used to choose laboratory-confirmed A (H7N9) cases for our study.85 patients were randomly selected from 139 laboratory-confirmed A (H7N9) cases in Zhejiang Province between March 1, 2013 and June 30, 2014. Data were collected using a standard method. To test the statistical significance among discrete variables, the univariate analyses were used to compare two groups. Next, the Kaplan-Meier product-limit method was used to analyze the patient survival fraction.Then, the Cox proportional hazards regression model was analyzed using all variables with p≤0.05 in univariate analyses. And lastly, a stepwise procedure was used to construct a final model with a significance level of p>0.10 for removal and p<0.05 for re-entry.
[h=4]RESULTS:[/h] A total of 85 patients with H7N9 virus infection were identified. Among whom, thirty (35.29%) died. In the univariate analysis, the following factors were associated with a high risk of influenza A(H7N9) case fatality: age ≥60 years (p=0.008), low education level (p=0.030), chronic diseases (p=0.029), poor hand hygiene (p=0.010), time from illness onset to the first medical visit (p=0.029) and to ICU (p=0.008), 5 days of incubation period or shorter (p=0.039), the peak of C-reactive protein≥120mg/L(p=0.012), increased initial neutrophil count(p=0.020), decreased initial lymphocytes count(p=0.021), and initial both lung infections (p=0.003). Multivariate analysis confirmed that the independent predictors of H7N9 virus infection mortalities in Zhejiang, China were hand hygiene (HR=5.163; 95%CI: 1.164-22.661), age (HR=1.042; 95%CI: 1.007-1.076), and peak of CRP (HR=1.009; 95%CI: 1.002-1.016).
[h=4]CONCLUSIONS:[/h] Immunity improvements, early case identification and treatment, and personal protection measures are keys to addressing the high human avian influenza A(H7N9) case fatality rates.
Copyright ? 2015. Published by Elsevier Ltd.
[h=4]KEYWORDS:[/h] Influenza; Influenza A Virus, H7N9 subtype; Outcome; Risk factors; human
PMID: 26376223 [PubMed - as supplied by publisher] Free full text
[h=1]Retrospective study of risk factors of mortality in human avian influenza A(H7N9) cases in Zhejiang Province, China, March 2013 to June 2014.[/h] Cheng QL[SUP]1[/SUP], Ding H[SUP]2[/SUP], Sun Z[SUP]2[/SUP], Kao QJ[SUP]2[/SUP], Yang XH[SUP]2[/SUP], Huang RJ[SUP]2[/SUP], Wen YY[SUP]2[/SUP], Wang J[SUP]2[/SUP], Xie L[SUP]3[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] The H7N9 virus is a serious disease that threatens human health. Fatalities associated with human infections caused by this disease are of great public health concerns; however, the possible risk factors are not yet fully known.
[h=4]METHODS:[/h] A stratified sampling method, incorporating household income levels and a random number table method, was used to choose laboratory-confirmed A (H7N9) cases for our study.85 patients were randomly selected from 139 laboratory-confirmed A (H7N9) cases in Zhejiang Province between March 1, 2013 and June 30, 2014. Data were collected using a standard method. To test the statistical significance among discrete variables, the univariate analyses were used to compare two groups. Next, the Kaplan-Meier product-limit method was used to analyze the patient survival fraction.Then, the Cox proportional hazards regression model was analyzed using all variables with p≤0.05 in univariate analyses. And lastly, a stepwise procedure was used to construct a final model with a significance level of p>0.10 for removal and p<0.05 for re-entry.
[h=4]RESULTS:[/h] A total of 85 patients with H7N9 virus infection were identified. Among whom, thirty (35.29%) died. In the univariate analysis, the following factors were associated with a high risk of influenza A(H7N9) case fatality: age ≥60 years (p=0.008), low education level (p=0.030), chronic diseases (p=0.029), poor hand hygiene (p=0.010), time from illness onset to the first medical visit (p=0.029) and to ICU (p=0.008), 5 days of incubation period or shorter (p=0.039), the peak of C-reactive protein≥120mg/L(p=0.012), increased initial neutrophil count(p=0.020), decreased initial lymphocytes count(p=0.021), and initial both lung infections (p=0.003). Multivariate analysis confirmed that the independent predictors of H7N9 virus infection mortalities in Zhejiang, China were hand hygiene (HR=5.163; 95%CI: 1.164-22.661), age (HR=1.042; 95%CI: 1.007-1.076), and peak of CRP (HR=1.009; 95%CI: 1.002-1.016).
[h=4]CONCLUSIONS:[/h] Immunity improvements, early case identification and treatment, and personal protection measures are keys to addressing the high human avian influenza A(H7N9) case fatality rates.
Copyright ? 2015. Published by Elsevier Ltd.
[h=4]KEYWORDS:[/h] Influenza; Influenza A Virus, H7N9 subtype; Outcome; Risk factors; human
PMID: 26376223 [PubMed - as supplied by publisher] Free full text