Different prognosis in hospitalized patients with influenza one season after the pandemic H1N1 influenza of 2009-2010 in Spain
Por:
Delgado-Rodriguez, M, Castilla, J, Godoy, P, Martin, V, Soldevila, N, Alonso, J, Astray, J, Baricot, M, Galan, JC, Castro, A, Gonzalez-Candelas, F, Mayoral, JM, Quintana, JM, Pumarola, T, Tamames, S, Saez, M, Dominguez, A, Bonfill X., López-Contreras J., Pomar V., Puig T., CIBERESP Cases Controls Pandemic
Publicada:
1 nov 2013
Resumen:
Background The present report compares prognosis in hospitalized cases with the H1N1 pandemic virus in two seasons.
Methods Two series of hospitalized patients with laboratory-confirmed H1N1 pandemic influenza have been compared: 813 in the season 2009-2010 and 707 in the season 2010-2011. A detailed history of variables preceding hospital admission and during hospitalization was obtained by interview and clinical charts. A combined endpoint of death admission to intensive care was used as outcome due to the low number of deaths. Logistic regression was applied in the analysis for adverse outcome.
Results Patients of the second season had different characteristics than in the first one (older, more underlying conditions, more malfunctioning organs and more symptoms). Patients with H1N1 pandemic virus when hospitalized were more frequently directly admitted to ICU during the 2010-2011 season than in the previous season (RR = 2.10; 95% confidence intervals CI, 1.55-2.85), as a consequence of a higher presence of sepsis and respiratory distress. These patients also showed during hospitalization a higher risk of ICU admission or death (RR = 3.22, 95% CI, 2.15-4.83). After adjusting for the differences in risk factors of adverse outcome, patients in the second season showed a higher risk of ICU admission and/or in-hospital death odds ratio (OR = 3.77, 95% CI, 2.30-6.18).
Conclusion Hospitalized patients with H1N1 pandemic influenza during the second season were more severely affected at hospital admission and showed a worse prognosis than in previous season, independently of the differences found at hospital admission.
Filiaciones:
Delgado-Rodriguez, M:
Univ Jaen, Jaen 23071, Spain
Inst Salud Carlos III, CIBERESP, Madrid, Spain
Castilla, J:
Inst Salud Carlos III, CIBERESP, Madrid, Spain
Inst Salud Publ Navarra, Pamplona, Spain
Godoy, P:
Inst Salud Carlos III, CIBERESP, Madrid, Spain
Generalitat Catalunya, Dept Salut, Barcelona, Spain
Martin, V:
Inst Salud Carlos III, CIBERESP, Madrid, Spain
Univ Leon, Inst Biomed, E-24071 Leon, Spain
Soldevila, N:
Inst Salud Carlos III, CIBERESP, Madrid, Spain
Alonso, J:
Inst Salud Carlos III, CIBERESP, Madrid, Spain
Hosp Mar, Inst Recerca, IMIM, Barcelona, Spain
Astray, J:
Comunidad Madrid, Area Epidemiol, Madrid, Spain
Baricot, M:
Inst Salud Carlos III, CIBERESP, Madrid, Spain
Galan, JC:
Inst Salud Carlos III, CIBERESP, Madrid, Spain
Hosp Univ Ramon y Cajal, Madrid, Spain
Castro, A:
Recinto Hosp Joan March, CIBER Enfermedades Resp, Mallorca, Illes Balears, Spain
Gonzalez-Candelas, F:
Inst Salud Carlos III, CIBERESP, Madrid, Spain
Univ Valencia, Ctr Super Invest Salud Publ, Valencia, Spain
Mayoral, JM:
Consejeria Salud, Serv Vigilancia Andalucia, Seville, Spain
Quintana, JM:
Inst Salud Carlos III, CIBERESP, Madrid, Spain
Hosp Galdakao Usansolo, Unidad Invest, Galdakao, Bizkaia, Spain
Pumarola, T:
ISCIII, REIPI, Madrid, Spain
Tamames, S:
Junta Castilla & Leon, Direcc Gen Salud Publ & Invest Desarrollo & Innov, Valladolid, Spain
Saez, M:
Univ Girona, Girona, Spain
Dominguez, A:
Inst Salud Carlos III, CIBERESP, Madrid, Spain
Univ Barcelona, Barcelona, Spain
Bonfill X.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
López-Contreras J.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Pomar V.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Puig T.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Green Published, Bronze
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