Risk factors associated with severe influenza virus infections in hospitalized children during the 2013 to 2014 season
Risk factors associated with severe influenza virus infections in hospitalized children during the 2013 to 2014 season
复制标题
DOI：
10.1016/j.jmii.2015.05.015
复制
发表时间：
2016-06-01
影响因子：
7.4
通讯作者：
Huang, Li-Min
中科院分区：
文献类型：
--
作者：
Ma, Hsuan-Yin;Wu, Jhong-Lin;Huang, Li-Min
背景：2013年10月至2014年5月，台湾爆发流感病毒感染。我们进行了一项临床研究，以确定与严重的流感病毒感染的儿童。方法：在爆发期间，从110例流感病毒感染住院儿童的数据收集。我们分析了数据、重症监护的需求和患者结局，以确定严重感染（定义为重症监护的需求）的临床特征和危险因素。结果：在110名住院患者中，有57名男性和53名女性患者;中位年龄为2.6（四分位距，1.0-6.3）岁。19名患者需要重症监护，2名患者死亡。体重不足（p = 0.01）或患有神经肌肉疾病（p = 0.007）和消化道疾病（p = 0.03）的儿童更容易发生严重感染。癫痫发作（p = 0.004）、意识障碍（p = 0.02）或入院时低氧饱和度（p = 0.04）的发生预示着需要重症监护。较高的初始中性粒细胞绝对计数（p = 0.02）和胸部X线检查的斑片或胸腔积液（p = 0.02）与严重感染相关。在多变量分析中，消化道疾病[p = 0.03;校正比值比（OR），12.37; 95%置信区间（CI），1.28-119.43]，癫痫发作（p = 0.001;校正OR，49.54; 95% CI，4.61 e532.76）和意识障碍（p = 0.006;校正OR，131.61; 95%CI，4.18-4141.64）与严重流感病毒感染最显著相关。在流感季节，建议密切监测重要的危险因素，包括潜在的消化道疾病、癫痫发作和意识障碍。Copyright（C）2015，Taiwan Society of Microbiology.出版社：Elsevier Taiwan LLC
Background: An outbreak of influenza virus infection occurred in Taiwan from October 2013 to May 2014. We conducted a clinical study to identify risk factors associated with severe influenza virus infections in children.Methods: During the outbreak period, data from 110 hospitalized children with influenza virus infection were collected. We analyzed the data, the need for intensive care, and patient outcome to identify clinical features and risk factors of severe infections, defined as the need of intensive care.Results: Of the 110 inpatients, there were 57 male and 53 female patients; the median age was 2.6 (interquartile range, 1.0-6.3) years. Nineteen patients required intensive care and two patients died. Children who were underweight (p = 0.01) or those with neuromuscular disease (p = 0.007) and digestive tract disease (p = 0.03) were prone to severe infection. Occurrence of seizure (p = 0.004), conscious disturbance (p = 0.02), or low oxygen saturation at admission (p = 0.04) predicted the need for intensive care. Higher initial absolute neutrophil count (p = 0.02) and patch or pleural effusion on chest X-ray examination (p = 0.02) were associated with severe infection. In the multivariable analysis, digestive tract disease [p = 0.03; adjusted odds ratio (OR), 12.37; 95% confidence interval (CI), 1.28-119.43], seizure (p = 0.001; adjusted OR, 49.54; 95% CI, 4.61e532.76) and conscious disturbance (p = 0.006; adjusted OR, 131.61; 95% CI, 4.18-4141.64) were most significantly associated with severe influenza virus infection.Conclusion: Close monitoring of the important risk factors including underlying digestive tract diseases, seizure attack and conscious disturbance were recommended during the influenza season. Copyright (C) 2015, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC.