Epidemiology and outcomes of adults with asthma who were hospitalized or died with 2009 pandemic influenza A (H1N1)--California, 2009.
Epidemiology and outcomes of adults with asthma who were hospitalized or died with 2009 pandemic influenza A (H1N1)--California, 2009.
复制标题
患有哮喘的成年人的流行病学和结果，他们住院或死于2009年大流行性流感A（H1N1） - 加利福尼亚，2009年。
DOI：
10.1111/irv.12120
复制
发表时间：
2013-11
影响因子：
4.4
通讯作者：
Matyas BT
中科院分区：
文献类型：
--
作者：
Mortensen E;Louie J;Pertowski C;Cadwell BL;Weiss E;Acosta M;Matyas BT
在因2009年甲型H1N1流感（pH1N1）住院的成年人中，哮喘是最常见的慢性疾病。我们描述了加州因pH1N1而住院或死亡的成人哮喘患者的流行病学和严重结局的因素。我们回顾了2009年4月23日至2009年8月11日加利福尼亚公共卫生部的pH1N1报告。如果住院或死亡的成人（年龄≥18岁）哮喘患者通过聚合酶链反应感染pH1N1（或非亚型甲型流感），则纳入报告。在常规药物治疗的基础上，将患者分为间歇性或持续性哮喘。通过卡方检验和逻辑回归评估与严重结局（即重症监护病房入住或死亡）相关的风险因素与不严重结局相关的风险因素。在744例确诊患者中，170例（23%）患有哮喘（61%为间歇性，39%为持续性）。142名患者中有132名（93%）患有其他慢性疾病。162例患者中有54例（33%）出现严重后果，肾病患者（64%对31%，P = 0.04）和胸片浸润患者（54%对11%，P < 0.01）更为常见，在症状出现48小时内接受抗病毒药物治疗的患者较不常见（22%对44%，P = 0.02）。在多变量分析中，胸片浸润与严重结局相关（调整优势比为9.38,95%可信区间为3.05 - 28.90）。因pH1N1死亡或住院的成人哮喘患者中，有三分之一经历了严重的后果。应鼓励早期经验性抗病毒治疗，特别是在哮喘患者中。
Asthma was the most common chronic condition among adults hospitalized for 2009 pandemic influenza A (H1N1) (pH1N1). We describe the epidemiology and factors for severe outcomes among adults with asthma who were hospitalized or died from pH1N1 in California. We reviewed California Department of Public Health pH1N1 reports from April 23, 2009 through August 11, 2009. Reports were included if the patient had pH1N1 (or non‐subtypeable influenza A) infection by polymerase chain reaction in an adult (age ≥ 18 years) with asthma who was hospitalized or died. Patients were classified as having intermittent or persistent asthma on the basis of regular medications. Risk factors associated with severe outcomes (i.e., intensive care unit admission or death) vs those with less severe outcomes were assessed by chi‐square tests and logistic regression. Among 744 identified patients, 170 (23%) had asthma (61% intermittent, 39% persistent). 132 of 142 (93%) patients had other chronic medical conditions. Severe outcomes occurred in 54 of 162 (33%), more commonly among those with renal disease (64% versus 31%; P = 0.04) and chest radiograph infiltrates (54% versus 11%; P < 0.01), less commonly among those who received antivirals within 48 hours of symptom onset (22% versus 44%; P = 0.02). In multivariable analysis, chest radiograph infiltrates were associated with severe outcomes (adjusted odds ratio 9·38, 95% confidence interval 3·05–28·90). One third of adults with asthma who died or were hospitalized with pH1N1 experienced severe outcomes. Early empiric antiviral therapy should be encouraged, especially among asthma patients.