tetano
Editor, Senior Moderator
Respir Med. 2011 May 9. [Epub ahead of print]
Risk factors of A/H1N1 etiology in pneumonia and its impact on mortality.
Reyes S, Montull B, Mart?nez R, C?rdoba J, Molina JM, Mart? V, Mart?nez A, Ram?rez P, Men?ndez R.
Source
Service of Pneumology, Hospital Universitario y Polit?cnico La Fe, Valencia, Spain.
Abstract
OBJECTIVE:
Pandemic 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.
METHODS:
Retrospective observational study in 364 consecutive patients hospitalized with pneumonia during the A/H1N1 pandemic flu, April-December 2009.
RESULTS:
294 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/mm(3) (OR 3.4). Risk factors for in-hospital mortality in the whole group were A/H1N1 (+) etiology and LDH > 600IU/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 > 600IU/L (OR 10.5) were risk factors for in-hospital mortality in A/H1N1(+) patients (AUC 0.81)
CONCLUSION:
Leukopenia, 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.
Copyright ? 2011 Elsevier Ltd. All rights reserved.
PMID:
21561754
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21561754
Risk factors of A/H1N1 etiology in pneumonia and its impact on mortality.
Reyes S, Montull B, Mart?nez R, C?rdoba J, Molina JM, Mart? V, Mart?nez A, Ram?rez P, Men?ndez R.
Source
Service of Pneumology, Hospital Universitario y Polit?cnico La Fe, Valencia, Spain.
Abstract
OBJECTIVE:
Pandemic 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.
METHODS:
Retrospective observational study in 364 consecutive patients hospitalized with pneumonia during the A/H1N1 pandemic flu, April-December 2009.
RESULTS:
294 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/mm(3) (OR 3.4). Risk factors for in-hospital mortality in the whole group were A/H1N1 (+) etiology and LDH > 600IU/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 > 600IU/L (OR 10.5) were risk factors for in-hospital mortality in A/H1N1(+) patients (AUC 0.81)
CONCLUSION:
Leukopenia, 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.
Copyright ? 2011 Elsevier Ltd. All rights reserved.
PMID:
21561754
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21561754