کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4210312 1280579 2011 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Risk factors of A/H1N1 etiology in pneumonia and its impact on mortality
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پزشکی ریوی و تنفسی
پیش نمایش صفحه اول مقاله
Risk factors of A/H1N1 etiology in pneumonia and its impact on mortality
چکیده انگلیسی

SummaryObjectivePandemic flu has changed the epidemiology of pneumonia, thus challenging the prediction of etiology and outcome. We analyze the risk factors to predict influenza A/H1N1 infection in patients with pneumonia, and the impact of this etiology on mortality during a pandemic period. Differences between pneumonia with or without A/H1N1 coinfection are described.MethodsRetrospective observational study in 364 consecutive patients hospitalized with pneumonia during the A/H1N1 pandemic flu, April–December 2009.Results294 patients (80.5%) had A/H1N1(−) pneumonia, 47 (13.2%) A/H1N1(+) pneumonia, and 23 (6.3%) coinfection. Mortality during hospitalization was 24/294 (8.2%), 8/47 (16.7%), 2/23 (8.7%) respectively. A regression logistic analysis (Area under curve, AUC 0.81) to predict A/H1N1(+) pneumonia identified four independent variables: age < 60 years (Odds ratio, OR 5.9), multilobar infiltrates (OR 7.7), C-reactive protein (CRP) < 10 mg/dL (OR 2.8), and leukopenia < 5000/mm3 (OR 3.4). Risk factors for in-hospital mortality in the whole group were A/H1N1 (+) etiology and LDH > 600 IU/L (OR 4.1) when adjusting for PSI, and hypoxemia (OR 4.2) when adjusting for CURB 65 (AUC 0.81). Heart disease (OR 27.4) and LDH > 600 IU/L (OR 10.5) were risk factors for in-hospital mortality in A/H1N1(+) patients (AUC 0.81)ConclusionLeukopenia, multilobar infiltrates, CRP<10 mg/dl and age < 60 years were independently associated with A/H1N1(+) etiology. Pandemic A/H1N1(+) increased mortality pneumonia. Heart disease and LDH > 600 were independently associated with mortality in A/H1N1(+) pneumonia.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Respiratory Medicine - Volume 105, Issue 9, September 2011, Pages 1404–1411
نویسندگان
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