tetano
Editor, Senior Moderator
Infection. 2019 Jun 15. doi: 10.1007/s15010-019-01335-0. [Epub ahead of print]
[h=1]Influenza virus infection: an approach to identify predictors for in-hospital and 90-day mortality from patients in Vienna during the season 2017/18.[/h] Pawelka E[SUP]1[/SUP], Karolyi M[SUP]2[/SUP], Daller S[SUP]3[/SUP], Kaczmarek C[SUP]3[/SUP], Laferl H[SUP]1[/SUP], Niculescu I[SUP]1[/SUP], Schrader B[SUP]3[/SUP], St?tz C[SUP]3[/SUP], Zoufaly A[SUP]1[/SUP], Wenisch C[SUP]1[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Seasonal influenza outbreaks are associated with increased mortality and hospitalisation rates. Herein we tried to identify predictors of mortality in hospitalised patients with influenza virus infection.
[h=4]MATERIALS/METHODS:[/h] In this exploratory retrospective observational single-centre-study we included all influenza-positive patients older than 18 years who were hospitalised and treated at the flu-isolation-ward during the influenza season 2017/18. Diagnosis was based on point-of-care-test with the Alere? i. First we performed χ[SUP]2[/SUP] tests and Mann-Whitney U tests to identify predictors of mortality. Significant variables were used in a stepwise-forward-logistic-regression-model to predict in-hospital and 90-day mortality.
[h=4]RESULTS:[/h] Of the 396 patients who tested positive for influenza 96 (24.2%) had influenza A and 300 (75.8%) influenza B. Twenty-two (5.6%) died in hospital and the 90-day mortality rate was 9.4%. In the stepwise logistic regression older age (OR 1.1 per year 95% CI 1.03-1.17), history of atrial fibrillation (OR 5.91 95% CI 1.91-18.34), dementia (OR 3.98 95% CI 1.24-12.78), leucocyte count (OR 1.11 per G/L 95% CI 1.03-1.20), pneumonia (OR 4.39 95% CI 1.44-13.39) and acute heart failure (OR 23.15 95% CI 4.33-123.76) increased the risk of in-hospital mortality. The risk for 90-day mortality was increased by older age (OR 1.04 per year 95% CI 1.01-1.07), history of atrial fibrillation (OR 3.1, 95% CI 1.36-7.05), history of congestive heart failure (OR 4.7 95% CI 1.94-11.48), pneumonia (OR 3.2 95% CI 1.45-6.91) and decreased by statin use (OR 0.28 95% CI 0.10-0.78).
[h=4]CONCLUSIONS:[/h] Older age, history of atrial fibrillation and pneumonia are associated with increased risk of influenza-associated in-hospital and 90-day mortality. Statin use may decrease 90-day mortality.
[h=4]KEYWORDS:[/h] 90 day mortality; Flu; Influenza; Mortality; POCT; Predictors
PMID: 31203513 DOI: 10.1007/s15010-019-01335-0
[h=1]Influenza virus infection: an approach to identify predictors for in-hospital and 90-day mortality from patients in Vienna during the season 2017/18.[/h] Pawelka E[SUP]1[/SUP], Karolyi M[SUP]2[/SUP], Daller S[SUP]3[/SUP], Kaczmarek C[SUP]3[/SUP], Laferl H[SUP]1[/SUP], Niculescu I[SUP]1[/SUP], Schrader B[SUP]3[/SUP], St?tz C[SUP]3[/SUP], Zoufaly A[SUP]1[/SUP], Wenisch C[SUP]1[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Seasonal influenza outbreaks are associated with increased mortality and hospitalisation rates. Herein we tried to identify predictors of mortality in hospitalised patients with influenza virus infection.
[h=4]MATERIALS/METHODS:[/h] In this exploratory retrospective observational single-centre-study we included all influenza-positive patients older than 18 years who were hospitalised and treated at the flu-isolation-ward during the influenza season 2017/18. Diagnosis was based on point-of-care-test with the Alere? i. First we performed χ[SUP]2[/SUP] tests and Mann-Whitney U tests to identify predictors of mortality. Significant variables were used in a stepwise-forward-logistic-regression-model to predict in-hospital and 90-day mortality.
[h=4]RESULTS:[/h] Of the 396 patients who tested positive for influenza 96 (24.2%) had influenza A and 300 (75.8%) influenza B. Twenty-two (5.6%) died in hospital and the 90-day mortality rate was 9.4%. In the stepwise logistic regression older age (OR 1.1 per year 95% CI 1.03-1.17), history of atrial fibrillation (OR 5.91 95% CI 1.91-18.34), dementia (OR 3.98 95% CI 1.24-12.78), leucocyte count (OR 1.11 per G/L 95% CI 1.03-1.20), pneumonia (OR 4.39 95% CI 1.44-13.39) and acute heart failure (OR 23.15 95% CI 4.33-123.76) increased the risk of in-hospital mortality. The risk for 90-day mortality was increased by older age (OR 1.04 per year 95% CI 1.01-1.07), history of atrial fibrillation (OR 3.1, 95% CI 1.36-7.05), history of congestive heart failure (OR 4.7 95% CI 1.94-11.48), pneumonia (OR 3.2 95% CI 1.45-6.91) and decreased by statin use (OR 0.28 95% CI 0.10-0.78).
[h=4]CONCLUSIONS:[/h] Older age, history of atrial fibrillation and pneumonia are associated with increased risk of influenza-associated in-hospital and 90-day mortality. Statin use may decrease 90-day mortality.
[h=4]KEYWORDS:[/h] 90 day mortality; Flu; Influenza; Mortality; POCT; Predictors
PMID: 31203513 DOI: 10.1007/s15010-019-01335-0