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Predictors of mortality of influenza virus infections in a Swiss Hospital during four influenza seasons: Role of quick sequential organ failure assessment

2019; Elsevier BV; Volume: 74; Linguagem: Inglês

10.1016/j.ejim.2019.12.022

1879-0828

Matthaios Papadimitriou‐Olivgeris, Nikitas Gkikopoulos, Melissa Wüst, Aurelie Ballif, Valentin Simonin, M Maulini, Charly Nusbaumer, Luce Bertaiola Monnerat, Jonathan Tschopp, Eleftheria Kampouri, Patrick C. Wilson, Hervé Duplain,

Viral gastroenteritis research and epidemiology

Abstract Background Influenza infections have been associated with high morbidity. The aims were to determine predictors of mortality among patients with influenza infections and to ascertain the role of quick Sequential Organ Failure Assessment (qSOFA) in predicting poor outcomes. Methods All adult patients with influenza infection at the Hospital of Jura, Switzerland during four influenza seasons (2014/15 to 2017/18) were included. Cepheid Xpert Xpress Flu/RSV was used during the first three influenza seasons and Cobas Influenza A/B and RSV during the 2017/18 season. Results Among 1684 influenza virus tests performed, 441 patients with influenza infections were included (238 for influenza A virus and 203 for B). The majority of infections were community onset (369; 83.7%). Thirty-day mortality was 6.0% (25 patients). Multivariate analysis revealed that infection due to A virus ( P 0.035; OR 7.1; 95% CI 1.1–43.8), malnutrition ( P < 0.001; OR 25.0; 95% CI 4.5–138.8), hospital-acquired infection ( P 0.003; OR 12.2; 95% CI 2.3–65.1), respiratory insufficiency (PaO 2 /FiO 2 < 300) ( P < 0.001; OR 125.8; 95% CI 9.6–1648.7) and pulmonary infiltrate on X-ray ( P 0.020; OR 6.0; 95% CI 1.3–27.0) were identified as predictors of mortality. qSOFA showed a very good accuracy (0.89) equivalent to other more specific and burdensome scores such as CURB-65 and Pneumonia Severity Index (PSI). Conclusion qSOFA performed similarly to specific severity scores (PSI, CURB-65) in predicting mortality. Infection by influenza A virus, respiratory insufficiency and malnutrition were associated with worse prognosis.