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Rev Clin Esp . National retrospective cohort study to identify risk factors for in-hospital 30-day lethality in laboratory-confirmed cases of influe

tetano

Editor, Senior Moderator
Rev Clin Esp


. 2020 Jul 13;S0014-2565(20)30177-6.
doi: 10.1016/j.rce.2020.05.016. Online ahead of print.
National retrospective cohort study to identify risk factors for in-hospital 30-day lethality in laboratory-confirmed cases of influenza


[Article in En, Spanish]

E Murillo-Zamora[SUP] 1 [/SUP], O Mendoza-Cano[SUP] 2 [/SUP], I Delgado-Enciso[SUP] 3 [/SUP], J Guzm?n-Esquivel[SUP] 4 [/SUP]



Affiliations

Abstract

Objective: To identify factors associated with the risk of death in adolescent and adult inpatients with laboratory-positive (reverse-transcription polymerase chain reaction) influenza in Mexico during consecutive influenza seasons (2018-2020).
Patients and methods: A retrospective cohort study used national surveillance system data, enrolling 3422 individuals. The association between various risk factors and 30-day in-hospital lethality were evaluated through risk ratios (RR) and 95% confidence intervals (CI).
Results: The lethality rate was 18.1%. Flu vaccination history (RR = 0.56, 95% CI 0.42-0.78), early antiviral drug administration (≤ two days from symptom onset [reference ≥ 5 days], RR = 0.68, 95% CI 0.58-0.81), and a history of asthma (RR = 0.66, 95% CI 0.47-0.95) showed protective effects against influenza-attributable death. Mechanical ventilator support produced the highest increase in death risk (RR = 3.31, 95% CI 2.89-3.79). Male sex, older age, AH1N1 subtype, and other chronic diseases were also associated with fatal in-hospital influenza-related outcomes.
Conclusions: Our findings highlight the major relevance of promoting immunization in high-risk individuals, together with ensuring early and effective antiviral management in suspected influenza cases.

Keywords: Estudios retrospectivos; Gripe; Hospital mortality; Human; Humano; Influenza; Mexico; Mortalidad hospitalaria; M?xico; Reacci?n en cadena de la polimerasa con transcriptasa inversa; Retrospective studies; Reverse transcriptase polymerase chain reaction.
 
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