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Predictors of fatality in pandemic influenza A (H1N1) virus infection among adults

2014; BioMed Central; Volume: 14; Issue: 1 Linguagem: Inglês

10.1186/1471-2334-14-317

1471-2334

Önder Ergönül, Servet Alan, Öznur Ak, Fatma Basak Sargin, Arzu Kantürk, Alper Gündüz, Derya Öztürk-Engin, Oral Öncül, İ̇lker İnanç Balkan, Bahadır Ceylan, Nur Benzonana, Saadet Yazıcı, Funda Şimşek, Nuray Uzun, Asuman İnan, Gülhan Eren, Meral A. Cıblak, Kenan Midilli, Mustafa Özyurt, Selim Badur, Serap Gençer, Özcan Nazlıcan, Serdar Özer, Nail Özgüneş, Taner Yıldırmak, Turan Aslan, Paşa Göktaş, Neşe Saltoğlu, Muzaffer Fıncancı, Ali İhsan Dokucu, Haluk Eraksoy,

Travel-related health issues

The fatality attributed to pandemic influenza A H1N1 was not clear in the literature. We described the predictors for fatality related to pandemic influenza A H1N1 infection among hospitalized adult patients. This is a multicenter study performed during the pandemic influenza A H1N1 [A(H1N1)pdm09] outbreak which occurred in 2009 and 2010. Analysis was performed among laboratory confirmed patients. Multivariate analysis was performed for the predictors of fatality. In the second wave of the pandemic, 848 adult patients were hospitalized because of suspected influenza, 45 out of 848 (5.3%) died, with 75% of fatalities occurring within the first 2 weeks of hospitalization. Among the 241 laboratory confirmed A(H1N1)pdm09 patients, the case fatality rate was 9%. In a multivariate logistic regression model that was performed for the fatalities within 14 days after admission, early use of neuraminidase inhibitors was found to be protective (Odds ratio: 0.17, confidence interval: 0.03-0.77, p = 0.022), nosocomial infections (OR: 5.7, CI: 1.84-18, p = 0.013), presence of malignant disease (OR: 3.8, CI: 0.66-22.01, p = 0.133) significantly increased the likelihood of fatality. Early detection of the infection, allowing opportunity for the early use of neuraminidase inhibitors, was found to be important for prevention of fatality. Nosocomial bacterial infections and underlying malignant diseases increased the rate of fatality.