Incidence of hospital admissions and severe outcomes during the first and second waves of pandemic (H1N1) 2009
Incidence of hospital admissions and severe outcomes during the first and second waves of pandemic (H1N1) 2009
复制标题
DOI：
10.1503/cmaj.100746
复制
发表时间：
2010-12-14
影响因子：
14.6
通讯作者：
Pelletier, Louise
中科院分区：
文献类型：
--
作者：
Helferty, Melissa;Vachon, Julie;Pelletier, Louise
背景资料：在2009年大流行期间，加拿大经历了两次不同的大流行（H1N1）流感浪潮，一次在2009年春季，第二次在2009年初秋。我们比较了住院率和严重后果（入住重症监护室[ICU]和死亡）。方法：我们回顾了2009年4月18日至4月3日所有省份和地区向加拿大公共卫生署报告的所有实验室确诊的大流行性（H1N1）流感病例的数据，这些病例导致住院、ICU住院或死亡，2010.Results:在大流行和高峰期后，共有8678例住院（包括1473例ICU住院）和428例死亡与大流行（H1N1）流感有关。与第一波相比，第二波大流行的入院人数增加了4.8倍，ICU入院人数增加了4.0倍，死亡人数增加了4.6倍。第二波中，ICU入院和死亡人数占入院人数的比例下降;与第一波相比，ICU入院人数下降了16%，死亡人数下降了6%。与第一波入院的患者相比，第二波入院的患者年龄更大（中位年龄30 v. 23岁），更多患者患有基础疾病（59.7% v. 47.5%）。孕妇和原住民在第二波中住院或死亡的患者比例低于第一波。解释：2009年大流行的第一波和第二波的流行病学特征不同。第二波大得多，虽然入院的患者年龄较大，而且更多的人有基础疾病，但有更小比例的患者有严重的结局。
Background: Canada experienced two distinct waves of pandemic (H1N1) influenza during the 2009 pandemic, one in the spring and the second in early fall 2009. We compared the incidence of hospital admissions and severe outcomes (admission to intensive care unit [ICU] and death) during the two waves.Methods: We reviewed data on all laboratory-confirmed cases of pandemic (H1N1) influenza that resulted in hospital admission, ICU admission or death reported to the Public Health Agency of Canada by all provinces and territories from Apr. 18, 2009, to Apr. 3, 2010.Results: A total of 8678 hospital admissions (including 1473 ICU admissions) and 428 deaths related to pandemic (H1N1) influenza were reported during the pandemic and post-peak period. There were 4.8 times more hospital admissions, 4.0 times more ICU admissions and 4.6 times more deaths in the second pandemic wave than in the first wave. ICU admissions and deaths as a proportion of hospital admissions declined in the second wave; there was a 16% proportional decline in ICU admissions and a 6% proportional decline in deaths compared with the first wave. Compared with patients admitted to hospital in the first wave, those admitted in the second wave were older (median age 30 v. 23 years) and more had underlying conditions (59.7% v. 47.5%). Pregnant women and Aboriginal people accounted for proportionally fewer patients who were admitted to hospital or who died in the second wave than in the first.Interpretation: The epidemiologic features of the first and second waves of the 2009 pandemic differed. The second wave was substantially larger and, although the patients admitted to hospital were older and more of them had underlying conditions, a smaller proportion had a severe outcome.