Pandemic and post-pandemic influenza A (H1N1) seasons in a tertiary care university hospital-high rate of complications compared to previous influenza seasons.

Autor:	Bauernfeind, S., Bruennler, T., Ehrenstein, B., Langgartner, J., Wenzel, J., Werner, S., Lubnow, M., Mueller, T., Floerchinger, B., Salzberger, B.
Předmět:	ANTIVIRAL agents OSELTAMIVIR ACADEMIC medical centers CHI-squared test DISEASES EXTRACORPOREAL membrane oxygenation HYPERTENSION INTENSIVE care units SCIENTIFIC observation POLYMERASE chain reaction T-test (Statistics) U-statistics COMORBIDITY EQUIPMENT & supplies SEVERITY of illness index H1N1 influenza DATA analysis software DISEASE complications THERAPEUTICS
Zdroj:	Infection; Feb2013, Vol. 41 Issue 1, p145-150, 6p, 3 Charts
Abstrakt:	Introduction: The aim was to study the characteristics and case severity of patients hospitalized for influenza with a pandemic strain at a German tertiary care university hospital in 2009/10 and 2010/11 and to compare them to two previous influenza seasons. Methods: An observational study of all patients hospitalized for laboratory-confirmed influenza during the last four influenza seasons at Regensburg University Hospital was undertaken. Results: During the last four seasons, a rising number of patients were admitted due to influenza (4 in 2007/8, 16 in 2008/9, 27 in 2009/10, and 55 in 2010/11). Patients seen in the last two seasons were younger (median age 63 years in 2007/8, 52 years in 2008/9, 42 years in 2009/10, and 48 years in 2010/11) ( p = 0.046) and presented with a lower rate of major comorbidities (75 % in 2007/8, 62.5 % in 2008/9, 37 % in 2009/10, and 47.3 % in 2010/11). The pandemic and post-pandemic seasons were characterized by a high rate of seriously ill patients with longer hospitalizations (11 days in 2007/8, 7 days in 2008/9, 22 days in 2009/10 and 2010/11) ( p = 0.004) and higher rates of intensive care unit (ICU) admission (25 % in 2007/8, 18.8 % in 2008/9, 66.7 % in 2009/10, and 52.7 % in 2010/11) ( p = 0.003) and mechanical ventilation (25 % in 2007/8, 6.3 % in 2008/9, 63 % in 2009/10, and 49.1 % in 2010/11) ( p < 0.001). Extracorporeal membrane oxygenation (ECMO) was necessary in 33.3 % of patients in 2009/10 and 25.5 % in 2010/11. We had six fatalities in both pandemic and post-pandemic seasons. Conclusion: Compared to seasonal influenza, we observed even more so in the post-pandemic than the pandemic season a higher number of younger patients, with less serious comorbidities often showing a very severe course. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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