tetano
Editor, Senior Moderator
J Am Geriatr Soc. 2013 Mar 15. doi: 10.1111/jgs.12152. [Epub ahead of print]
Epidemiology, Clinical Features, and Prognosis of Elderly Adults with Severe Forms of Influenza A (H1N1).
Garnacho-Montero J, Guti?rrez-Pizarraya A, M?rquez JA, Zaragoza R, Granada R, Ruiz-Santana S, Rello J, Rodr?guez A; The Spanish Society of Intensive Care Medicine and Coronary Units Working Group.
Source
Critical Care and Emergency Department, Hospital Virgen del Roc?o, Seville, Spain.
Abstract
OBJECTIVES:
To examine epidemiological and clinical data of individuals aged 65 and older with influenza virus A (H1N1) admitted to the intensive care unit (ICU) and to identify independent predictors of ICU mortality.
DESIGN:
Prospective, observational, multicenter study to determine prognostic factors in individuals infected with influenza A (H1N1) admitted to the ICU.
SETTING:
One hundred forty-eight Spanish ICUs.
PARTICIPANTS:
Individuals with influenza A (H1N1) confirmed using real-time polymerase chain reaction from April 2009 to July 2011.
MEASUREMENTS:
Individuals aged 65 and older were compared with younger individuals. A multivariate analysis was conducted to determine independent predictors of mortality in this population.
RESULTS:
One thousand one hundred twenty individuals (129 (11.5%) aged ≥65) were included. Prevalence of chronic diseases was more common in older individuals. Viral pneumonitis was more frequent in individuals younger than 65 (70.5% vs 54.3%, P < .001). In older individuals, Acute Physiology and Chronic Health Evaluation II score (odds ratio (OR) = 1.11, 95% confidence interval (CI) = 1.11-1.20, P = .002), immunosuppression (OR = 3.66, 95% CI, 1.33-10.03, P = .01) and oseltamivir therapy initiated after 48 hours (OR = 3.32, 95% CI = 1.02-10.8, P = .04) were identified as independent variables associated with mortality. Corticosteroid use was associated with a trend toward greater mortality (OR = 2.39, 95% CI = 0.98-5.91, P = .06).
CONCLUSION:
Individuals aged 65 and older with influenza A (H1N1) admitted to the ICU have a higher incidence of underlying diseases than younger individuals and differences in clinical presentation. Early oseltamivir therapy is associated with better outcomes in elderly adults.
? 2013, Copyright the Authors Journal compilation ? 2013, The American Geriatrics Society.
PMID:
23496351
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/23496351
Epidemiology, Clinical Features, and Prognosis of Elderly Adults with Severe Forms of Influenza A (H1N1).
Garnacho-Montero J, Guti?rrez-Pizarraya A, M?rquez JA, Zaragoza R, Granada R, Ruiz-Santana S, Rello J, Rodr?guez A; The Spanish Society of Intensive Care Medicine and Coronary Units Working Group.
Source
Critical Care and Emergency Department, Hospital Virgen del Roc?o, Seville, Spain.
Abstract
OBJECTIVES:
To examine epidemiological and clinical data of individuals aged 65 and older with influenza virus A (H1N1) admitted to the intensive care unit (ICU) and to identify independent predictors of ICU mortality.
DESIGN:
Prospective, observational, multicenter study to determine prognostic factors in individuals infected with influenza A (H1N1) admitted to the ICU.
SETTING:
One hundred forty-eight Spanish ICUs.
PARTICIPANTS:
Individuals with influenza A (H1N1) confirmed using real-time polymerase chain reaction from April 2009 to July 2011.
MEASUREMENTS:
Individuals aged 65 and older were compared with younger individuals. A multivariate analysis was conducted to determine independent predictors of mortality in this population.
RESULTS:
One thousand one hundred twenty individuals (129 (11.5%) aged ≥65) were included. Prevalence of chronic diseases was more common in older individuals. Viral pneumonitis was more frequent in individuals younger than 65 (70.5% vs 54.3%, P < .001). In older individuals, Acute Physiology and Chronic Health Evaluation II score (odds ratio (OR) = 1.11, 95% confidence interval (CI) = 1.11-1.20, P = .002), immunosuppression (OR = 3.66, 95% CI, 1.33-10.03, P = .01) and oseltamivir therapy initiated after 48 hours (OR = 3.32, 95% CI = 1.02-10.8, P = .04) were identified as independent variables associated with mortality. Corticosteroid use was associated with a trend toward greater mortality (OR = 2.39, 95% CI = 0.98-5.91, P = .06).
CONCLUSION:
Individuals aged 65 and older with influenza A (H1N1) admitted to the ICU have a higher incidence of underlying diseases than younger individuals and differences in clinical presentation. Early oseltamivir therapy is associated with better outcomes in elderly adults.
? 2013, Copyright the Authors Journal compilation ? 2013, The American Geriatrics Society.
PMID:
23496351
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/23496351