Outcomes of patients with severe influenza infection admitted to intensive care units: a retrospective study in a medical centre

doi:10.1099/jmm.0.000593

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Title:	Outcomes of patients with severe influenza infection admitted to intensive care units: a retrospective study in a medical centre
Authors:	Chao, Chien-Ming Lai, Chih-Cheng Chan, Khee-Siang Cheng, Kuo-Chen Chou, Willy Yuan, Kuo-Shu Chen, Chin-Ming
Contributors:	Chi Mei Med Ctr, Dept Intens Care Med Chi Mei Med Ctr, Dept Intens Care Med Chung Hwa Univ Med Technol, Dept Safety Hlth & Environm Chi Mei Med Ctr, Dept Internal Med Chia Nan Univ Pharm & Sci, Dept Recreat & Hlth Care Management Chi Mei Med Ctr, Dept Med Res Natl Sun Yat Sen Univ, Dept Business Management
Keywords:	Respiratory-Distress-Syndrome Critically-Ill Patients Risk-Factors Critical Illness H1N1 Influenza Complications Resuscitation Impact Virus
Date:	2017-10
Issue Date:	2018-11-30 15:53:30 (UTC+8)
Publisher:	Microbiology Soc
Abstract:	Purpose. This study assessed clinical manifestations and prognostic factors of critically ill patients with severe influenza admitted to the intensive care unit (ICU) in Taiwan's recent outbreak. Methodology. Patients admitted to ICU for severe influenza between January 1, 2015, and March 31, 2016, were identified and their medical records were retrospectively reviewed. The primary endpoints were outcomes and predictors of in-hospital mortality. Results. There were 125 patients with an average Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 20.8. Hypertension (62.4 %) and diabetes mellitus (40.8 %) were the two most common underlying diseases. Ninety-eight (78.4 %) patients had at least one organ failure: the lungs were the most common (71.2 %), followed by the heart (53.6 %). Two of the most common symptoms of patients at ICU admission were fever (68.0 %) and cough (78.4 %). Thirty-three patients (26.4 %) died; most (40.9 %) were middle-aged (50-65 years old). A Cox regression analysis showed that multiple organ failure (MOF) [ hazard ratio (HR)=3.618; 95% CI=1.058-13.662] was significantly associated with higher risk of death. In contrast, a fluid-negative balance within 7 days of admission (HR=0.362; 95% CI=0.140-0.934) was significantly associated with a lower risk of death. Conclusion. The mortality rate of severe influenza patients admitted to the ICU was high, especially in middle-aged adults. The risk of mortality was associated with >= 2 organ failures. A negative fluid balance predicts survival.
Relation:	Journal of Medical Microbiology, v.66, n.10, pp.1421-1428
Appears in Collections:	[Dept. of Recreation and Health-Care Management] Periodical Articles

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