Outcome of critically ill patients with influenza virus infection
Outcome of critically ill patients with influenza virus infection
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DOI：
10.1016/j.jcv.2009.07.015
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发表时间：
2009-11-01
影响因子：
8.8
通讯作者：
Gajic, Ognjen
中科院分区：
文献类型：
--
作者：
Li, Guangxi;Yilmaz, Murat;Gajic, Ognjen
背景资料：流感是发病和死亡的主要原因，对重症监护室（ICU）中的老年人和患有慢性合并症的患者造成的负担最大。一个准确的预后是至关重要的决策在大流行期间，以及interpandemic periods.Methods：进行了回顾性队列研究，以确定预后因素影响短期预后的危重患者确诊流感病毒感染。基线特征，实验室和诊断结果，ICU干预措施和并发症提取的医疗记录使用标准定义和比较医院的幸存者和非幸存者之间的单变量和多变量logistic回归analysis.Results：111例患者符合纳入标准。急性呼吸窘迫综合征（ARDS）并发ICU病程25例（23%），病死率52%。多变量logistic回归分析确定了以下医院死亡率的预测因素：急性生理学和慢性健康评估（APACHE）III预测死亡率（增加10%的比值比[OR] 1.49，95%置信区间[CI] 1.1-2.1），ARDS（OR 7.7，95% CI 2.3-29）和免疫抑制史（OR 7.19，95%CI 1.9-28）。APACH III预测死亡率，对于确诊流感病毒感染的重症患者，急性呼吸窘迫综合征的发生和免疫抑制史是导致住院死亡的独立危险因素。由爱思唯尔公司出版
Background: Influenza is a major cause of morbidity and mortality, with its greatest burden on the elderly and patients with chronic co-morbidities in the intensive care unit (ICU). An accurate prognosis is essential for decision-making during pandemic as well as interpandemic periods.Methods: A retrospective cohort study was conducted to determine prognostic factors influencing short term outcome of critically ill patients with confirmed influenza virus infection. Baseline characteristics, laboratory and diagnostic findings, ICU interventions and complications were abstracted from medical records using standard definitions and compared between hospital survivors and non-survivors with univariate and multivariate logistic regression analyses.Results: 111 patients met the inclusion criteria. Acute respiratory distress syndrome (ARDS) complicated ICU course in 25 (23%) of the patients, with mortality rate of 52%. Multivariate logistic regression analysis identified the following predictors of hospital mortality: Acute Physiology and Chronic Health Evaluation (APACHE) III predicted mortality (Odds ratio [OR] 1.49, 95% confidence interval [CI] 1.1-2.1 for 10% increase), ARDS (OR 7.7, 95% CI 2.3-29) and history of immunosuppression (OR 7.19,95% CI 1.9-28).Conclusions: APACH III predicted mortality, the development of ARDS and the history of immunosuppression are independent risk factors for hospital mortality in critically ill patients with confirmed influenza virus infection. Published by Elsevier B.V.