Risk factors associated with severe outcomes in adult hospitalized patients according to influenza type and subtype
Por:
Martinez, A, Soldevila, N, Romero-Tamarit, A, Torner, N, Godoy, P, Rius, C, Jane, M, Dominguez, A, Alseda, M, Alvarez, J, Arias, C, Balana, PJ, Barrabeig, I, Camps, N, Carol, M, Ferras, J, Ferrus, G, Follia, N, Bach, P, Martinez, A, Minguell, S, Parron, I, Plasencia, E, Sala-Farre, MR, Torra, R, Torres, J, Cayla, J, Gorrindo, P, Marcos, MA, Mosquera, MDM, Vilella, A, Anton, A, Pumarola, T, Campins, M, Garcia, D, Espejo, E, Freixas, N, Garcia, R, Maraver, E, Mas, D, Perez, R, Rebull, J, Pou, J, Garcia-Pardo, G, Olona, M, Barcenilla, F, Castellana, D, Navarro-Rubio, G, Force, LL
Publicada:
11 ene 2019
Resumen:
Seasonal influenza is a cause of hospitalization, especially in people with underlying disease or extreme age, and its severity may differ depending on the types and subtypes of circulating viruses. We investigated the factors associated with ICU admission or death in hospitalized patients with severe laboratory-confirmed influenza according to the viral type and subtype. An observational epidemiological study was carried out in patients aged >= 18 years from 12 Catalan hospitals between 2010 and 2016. For each reported case we collected demographic, virological and clinical characteristics. A mixed-effects logistic regression model was used to estimate crude and adjusted ORs. 1726 hospitalized patients were included: 595 (34.5%) were admitted to the ICU and 224 (13.0%) died. Lower ICU admission was associated with age >= 75 years in all influenza types and subtypes and with age 65-74 years for type A. In contrast, the 65-74 and >= 75 years age groups were associated with an increased risk of death in all types and subtypes, especially for type B (aOR 27.42, 95% CI: 4.95-151.93 and 15.96; 95% CI: 3.01-84.68). The comorbidity most closely associated with severe outcomes was immune deficiency, which was associated with death for type B (aOR 9.02, 95% CI: 3.05-26.69) and subtype A(H1N1)pdm09 (aOR 3.16, 95% CI: 1.77-5.66). Older age was a differential factor for ICU admission and death: it was associated with lower ICU admission but a risk factor for death. The comorbidity with the closest association with death was immune deficiency, mainly in influenza type B patients.
Filiaciones:
Martinez, A:
Generalitat Catalunya, Agencia Salut Publ Catalunya, Barcelona, Spain
CIBERESP, Madrid, Spain
Publ Hlth Agcy Catalonia, Barcelona, Spain
Soldevila, N:
CIBERESP, Madrid, Spain
Univ Barcelona, Dept Med, Barcelona, Spain
Romero-Tamarit, A:
CIBERESP, Madrid, Spain
Torner, N:
Generalitat Catalunya, Agencia Salut Publ Catalunya, Barcelona, Spain
CIBERESP, Madrid, Spain
Univ Barcelona, Dept Med, Barcelona, Spain
Publ Hlth Agcy Catalonia, Barcelona, Spain
Godoy, P:
Generalitat Catalunya, Agencia Salut Publ Catalunya, Barcelona, Spain
CIBERESP, Madrid, Spain
Publ Hlth Agcy Catalonia, Barcelona, Spain
Rius, C:
CIBERESP, Madrid, Spain
Agencia Salut Publ Barcelona, Barcelona, Spain
Publ Hlth Agcy Barcelona, Barcelona, Spain
Jane, M:
Generalitat Catalunya, Agencia Salut Publ Catalunya, Barcelona, Spain
CIBERESP, Madrid, Spain
Publ Hlth Agcy Catalonia, Barcelona, Spain
Dominguez, A:
CIBERESP, Madrid, Spain
Univ Barcelona, Dept Med, Barcelona, Spain
Alseda, M:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Alvarez, J:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Arias, C:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Balana, PJ:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Barrabeig, I:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Camps, N:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Carol, M:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Ferras, J:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Ferrus, G:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Follia, N:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Bach, P:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Martinez, A:
Generalitat Catalunya, Agencia Salut Publ Catalunya, Barcelona, Spain
CIBERESP, Madrid, Spain
Publ Hlth Agcy Catalonia, Barcelona, Spain
Minguell, S:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Parron, I:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Plasencia, E:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Sala-Farre, MR:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Torra, R:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Torres, J:
Publ Hlth Agcy Catalonia, Barcelona, Spain
Cayla, J:
Publ Hlth Agcy Barcelona, Barcelona, Spain
Gorrindo, P:
Publ Hlth Agcy Barcelona, Barcelona, Spain
Marcos, MA:
Hosp Clin Barcelona, Barcelona, Spain
Mosquera, MDM:
Hosp Clin Barcelona, Barcelona, Spain
Vilella, A:
Hosp Clin Barcelona, Barcelona, Spain
Anton, A:
Hosp Univ Vall dHebron, Barcelona, Spain
Pumarola, T:
Hosp Univ Vall dHebron, Barcelona, Spain
Campins, M:
Hosp Univ Vall dHebron, Barcelona, Spain
Garcia, D:
Hosp Josep Trueta, Girona, Spain
Espejo, E:
Hosp Terrassa, Terrassa, Spain
Freixas, N:
Mutua Terrassa, Terrassa, Spain
Garcia, R:
Mutua Terrassa, Terrassa, Spain
Maraver, E:
Hosp Altahia Manresa, Manresa, Spain
Mas, D:
Hosp Altahia Manresa, Manresa, Spain
Perez, R:
Hosp Altahia Manresa, Manresa, Spain
Rebull, J:
Hosp Verge Cinta, Tortosa, Spain
Pou, J:
Hosp St Joan de Deu, Esplugues, Spain
Garcia-Pardo, G:
Hosp Joan 23, Tarragona, Spain
Olona, M:
Hosp Joan 23, Tarragona, Spain
Barcenilla, F:
Hosp Arnau Vilanova, Lleida, Spain
Castellana, D:
Hosp Arnau Vilanova, Lleida, Spain
Navarro-Rubio, G:
Consorci Sanitari Parc Tauli, Sabadell, Spain
Force, LL:
Hosp Mataro, Mataro, Spain
Gold, Green Published
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