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Scopus: 29 cites, Web of Science: 21 cites,
Pandemic and post-pandemic Influenza A (H1N1) infection in critically ill patients
Martin-Loeches, Ignacio (Corporació Parc Taulí)
Díaz, Emili (Hospital Joan XXIII (Tarragona))
Vidaur, Loreto (Hospital Donostia (San Sebastián))
Torres, Antoni (Universitat de Barcelona)
Laborda, César (Vall d'Hebron Hospitals)
Granada, Rosa (Hospital de Bellvitge)
Bonastre, Juan (Hospital La Fe (Valencia))
Martín, Mar (Hospital La Candelaria (Tenerife))
Insausti, Josu (Hospital de Navarra (Pamplona))
Arenzana,Ángel (Hospital Virgen de la Macarena (Sevilla))
Guerrero, José Eugenio (Hospital Gregorio Marañón (Madrid))
Navarrete, Inés (Hospital V. de las Nieves (Granada))
Bermejo-Martin, Jesús (Hospital Clínico Universitario (Valladolid))
Suárez, David (Universitat Autònoma de Barcelona)
Rodriguez, Alejandro (Hospital Joan XXIII (Tarragona))

Data: 2011
Resum: Background: There is a vast amount of information published regarding the impact of 2009 pandemic Influenza A (pH1N1) virus infection. However, a comparison of risk factors and outcome during the 2010-2011 post-pandemic period has not been described. Methods: A prospective, observational, multi-center study was carried out to evaluate the clinical characteristics and demographics of patients with positive RT-PCR for H1N1 admitted to 148 Spanish intensive care units (ICUs). Data were obtained from the 2009 pandemic and compared to the 2010-2011 post-pandemic period. Results: Nine hundred and ninety-seven patients with confirmed An/H1N1 infection were included. Six hundred and forty-eight patients affected by 2009 (pH1N1) virus infection and 349 patients affected by the post-pandemic Influenza (H1N1)v infection period were analyzed. Patients during the post-pandemic period were older, had more chronic comorbid conditions and presented with higher severity scores (Acute Physiology And Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA)) on ICU admission. Patients from the post-pandemic Influenza (H1N1)v infection period received empiric antiviral treatment less frequently and with delayed administration. Mortality was significantly higher in the post-pandemic period. Multivariate analysis confirmed that haematological disease, invasive mechanical ventilation and continuous renal replacement therapy were factors independently associated with worse outcome in the two periods. HIV was the only new variable independently associated with higher ICU mortality during the post-pandemic Influenza (H1N1)v infection period. Conclusion: Patients from the post-pandemic Influenza (H1N1)v infection period had an unexpectedly higher mortality rate and showed a trend towards affecting a more vulnerable population, in keeping with more typical seasonal viral infection.
Drets: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades. Creative Commons
Llengua: Anglès
Document: article ; publishedVersion
Publicat a: Critical care, Vol. 15, N. R286 (November 2011) , p. 1-11, ISSN 1466-609X

DOI: 10.1186/cc10573

11 p, 422.4 KB

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