Predictors of clinical outcome in a national hospitalised cohort across both waves of the influenza A/H1N1 pandemic 2009–2010 in the UK
| Autor: | Joanne E. Enstone, Peter J. M. Openshaw, Puja R. Myles, Karl G. Nicholson, Wei Shen Lim, Robert C. Read, Elaine M. Gadd, Jonathan S. Nguyen-Van-Tam, Barbara Bannister, Malcolm G Semple, James McMenamin, Bruce Taylor, Colin Armstrong, Stephen J. Brett |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Pediatrics bronchoscopy Respiratory Infection Comorbidity medicine.disease_cause paediatric physician cytokine biology Cohort Studies Influenza A Virus H1N1 Subtype Risk Factors Pandemic Influenza A virus Medicine Young adult Child Respiratory infection tobacco and the lung clinical epidemiology Middle Aged paediatric asthma Prognosis lymphocyte biology Anti-Bacterial Agents Hospitalization Treatment Outcome Child Preschool Cohort Female Health education Cohort study Adult Pulmonary and Respiratory Medicine medicine.medical_specialty Adolescent Antiviral Agents Young Adult Age Distribution Influenza Human Humans influenza A virus pneumonia human Sex Distribution Pandemics Aged hospitalisation business.industry bacterial infection Infant asthma medicine.disease mortality Drug Utilization United Kingdom Influenza critical care H1N1 subtype Emergency medicine viral infection paediatric lung disaese business |
| Zdroj: | Thorax |
| ISSN: | 1468-3296 0040-6376 |
| DOI: | 10.1136/thoraxjnl-2011-200266 |
| Popis: | Background Although generally mild, the 2009–2010 influenza A/H1N1 pandemic caused two major surges in hospital admissions in the UK. The characteristics of patients admitted during successive waves are described. Methods Data were systematically obtained on 1520 patients admitted to 75 UK hospitals between May 2009 and January 2010. Multivariable analyses identified factors predictive of severe outcome. Results Patients aged 5–54 years were over-represented compared with winter seasonal admissions for acute respiratory infection, as were non-white ethnic groups (first wave only). In the second wave patients were less likely to be school age than in the first wave, but their condition was more likely to be severe on presentation to hospital and they were more likely to have delayed admission. Overall, 45% had comorbid conditions, 16.5% required high dependency (level 2) or critical (level 3) care and 5.3% died. As in 1918–1919, the likelihood of severe outcome by age followed a W-shaped distribution. Pre-admission antiviral drug use decreased from 13.3% to 10% between the first and second waves (p=0.048), while antibiotic prescribing increased from 13.6% to 21.6% (p |
| Databáze: | OpenAIRE |
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