Prognostic factors for fatal adult influenza pneumonia
Journal
Journal of Infection
Journal Volume
58
Journal Issue
6
Pages
439-445
Date Issued
2009
Author(s)
Ho Y.-C.
Wang J.-L.
Chang C.-W.
Wu H.-S.
Chen C.-H.
Chuang Y.-M.
Abstract
Objectives: To elucidate the prognostic factors for fatal adult influenza pneumonia. Methods: Complicated influenza pneumonia is a notifiable disease in Taiwan. In this retrospective nationwide cohort, medical records were reviewed in 38 qualifying cases from 2001 to 2007. In-hospital mortality was the primary endpoint of this study. Results: The median patient age was 52 years, with the in-hospital mortality rate of 44.7%. Influenza A virus was found in 25 patients and influenza B was in 13 patients. Fifty percent of patients had no comorbidities. More than half of the patients developed sepsis, septic shock, respiratory failure or acute respiratory distress syndrome. The median duration from symptom onset to hospital visit was 3 days, and from hospital visit to death was 4 days. A univariate analysis demonstrated poor prognosis in patients with shock, respiratory rate ?25/min, arterial pH < 7.35, creatinine ? 2 mg/dL and Pneumonia Severity Index IV or V. A multivariate analysis showed an association with mortality in patients with APACHE II score ?20 (hazard ratio 5.941, p = 0.024) or PaO2/FiO2 ratio <150 (hazard ratio 4.194, p = 0.017). Conclusions: Clinical knowledge of identified prognostic factors for mortality may aid management of adult influenza pneumonia. ? 2009 The British Infection Society.
SDGs
Other Subjects
creatinine; adolescent; adult; adult respiratory distress syndrome; aged; APACHE; arterial pH; article; breathing rate; clinical article; comorbidity; controlled study; creatinine blood level; disease duration; fatality; female; hospital admission; human; Influenza virus; Influenza virus A; Influenza virus B; male; medical record review; molecular phylogeny; mortality; Pneumonia Severity Index; prognosis; respiratory failure; retrospective study; sepsis; septic shock; Taiwan; throat culture; virus pneumonia; Adolescent; Adult; Aged; Aged, 80 and over; APACHE; Cohort Studies; Disease Notification; Female; Hospital Mortality; Humans; Influenza A virus; Influenza B virus; Influenza, Human; Length of Stay; Male; Middle Aged; Multivariate Analysis; Pneumonia, Viral; Prognosis; Respiratory Distress Syndrome, Adult; Respiratory Insufficiency; Retrospective Studies; RNA, Viral; Sepsis; Shock, Septic; Taiwan; Young Adult
Type
journal article