Predictors of severe H1N1 infection in children presenting within Pediatric Emergency Research Networks (PERN): retrospective case-control study
Identifieur interne : 000370 ( Main/Exploration ); précédent : 000369; suivant : 000371Predictors of severe H1N1 infection in children presenting within Pediatric Emergency Research Networks (PERN): retrospective case-control study
Auteurs : Stuart R. Dalziel [Nouvelle-Zélande] ; John Md Thompson [Nouvelle-Zélande] ; Charles G. Macias [États-Unis] ; Ricardo M. Fernandes [Portugal] ; David W. Johnson [Canada] ; Yehezkel Waisman [Israël] ; Nicholas Cheng [Australie] ; Jason Acworth [Australie] ; James M. Chamberlain [États-Unis] ; Martin H. Osmond [Canada] ; Amy Plint [Canada] ; Paolo Valerio [Pays-Bas] ; Karen Jl Black [Canada] ; Eleanor Fitzpatrick [Canada] ; Amanda S. Newton [Canada] ; Nathan Kuppermann [États-Unis] ; Terry P. Klassen [Canada]Source :
- BMJ : British Medical Journal [ 1756-1833 ] ; 2013.
Abstract
Objective To identify historical and clinical findings at emergency department presentation associated with severe H1N1 outcome in children presenting with influenza-like illness. Design Multicentre retrospective case-control study. Setting 79 emergency departments of hospitals associated with the Pediatric Emergency Research Networks in 12 countries. Participants 265 children (<16 years), presenting between 16 April and 31 December 2009, who fulfilled Centers for Disease Control and Prevention criteria for influenza-like illness and developed severe outcomes from laboratory confirmed H1N1 infection. For each case, two controls presenting with influenza-like illness but without severe outcomes were included: one random control and one age matched control. Main outcome measures Severe outcomes included death or admission to intensive care for assisted ventilation, inotropic support, or both. Multivariable conditional logistic regression was used to compare cases and controls, with effect sizes measured as adjusted odds ratios. Results 151 (57%) of the 265 cases were male, the median age was 6 (interquartile range 2.3-10.0) years, and 27 (10%) died. Six factors were associated with severe outcomes in children presenting with influenza-like illness: history of chronic lung disease (odds ratio 10.3, 95% confidence interval 1.5 to 69.8), history of cerebral palsy/developmental delay (10.2, 2.0 to 51.4), signs of chest retractions (9.6, 3.2 to 29.0), signs of dehydration (8.8, 1.6 to 49.3), requirement for oxygen (5.8, 2.0 to 16.2), and tachycardia relative to age). Conclusion These independent risk factors may alert clinicians to children at risk of severe outcomes when presenting with influenza-like illness during future pandemics.
Url:
DOI: 10.1136/bmj.f4836
Affiliations:
- Australie, Canada, Israël, Nouvelle-Zélande, Pays-Bas, Portugal, États-Unis
- Alberta, Californie, District de Columbia, Hollande-Septentrionale, Manitoba, Texas
- Amsterdam, Calgary, Washington (district de Columbia), Winnipeg
- Université de Calgary, Université du Manitoba
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Osmond</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>University of Ottawa and Children’s Hospital of Eastern Ontario, Ottawa, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Plint, Amy" sort="Plint, Amy" uniqKey="Plint A" first="Amy" last="Plint">Amy Plint</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>University of Ottawa and Children’s Hospital of Eastern Ontario, Ottawa, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Valerio, Paolo" sort="Valerio, Paolo" uniqKey="Valerio P" first="Paolo" last="Valerio">Paolo Valerio</name><affiliation wicri:level="3"><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Onze Lieve Vrouwe Gasthuis, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Black, Karen Jl" sort="Black, Karen Jl" uniqKey="Black K" first="Karen Jl" last="Black">Karen Jl Black</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>IWK Health Centre, Halifax, NS</wicri:regionArea><wicri:noRegion>NS</wicri:noRegion></affiliation></author><author><name sortKey="Fitzpatrick, Eleanor" sort="Fitzpatrick, Eleanor" uniqKey="Fitzpatrick E" first="Eleanor" last="Fitzpatrick">Eleanor Fitzpatrick</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>IWK Health Centre, Halifax, NS</wicri:regionArea><wicri:noRegion>NS</wicri:noRegion></affiliation></author><author><name sortKey="Newton, Amanda S" sort="Newton, Amanda S" uniqKey="Newton A" first="Amanda S" last="Newton">Amanda S. Newton</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>University of Alberta, Edmonton, AB</wicri:regionArea><wicri:noRegion>AB</wicri:noRegion></affiliation></author><author><name sortKey="Kuppermann, Nathan" sort="Kuppermann, Nathan" uniqKey="Kuppermann N" first="Nathan" last="Kuppermann">Nathan Kuppermann</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Departments of Emergency Medicine and Pediatrics, University of California, Davis School of Medicine, Davis, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Klassen, Terry P" sort="Klassen, Terry P" uniqKey="Klassen T" first="Terry P" last="Klassen">Terry P. Klassen</name><affiliation wicri:level="4"><country xml:lang="fr">Canada</country><wicri:regionArea>Manitoba Institute of Child Health, University of Manitoba, Winnipeg, MB</wicri:regionArea><orgName type="university">Université du Manitoba</orgName><placeName><settlement type="city">Winnipeg</settlement><region type="state">Manitoba</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">BMJ : British Medical Journal</title><title level="j" type="abbrev">BMJ</title><idno type="eISSN">1756-1833</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date type="published" when="2013">2013</date><biblScope unit="volume">347</biblScope></imprint></series><idno type="istex">0E21843AE507E4D6E533C5A7F568322B47E79342</idno><idno type="DOI">10.1136/bmj.f4836</idno><idno type="href">bmj-347-bmj-f4836.pdf</idno><idno type="ArticleID">dals009787</idno><idno type="local">bmj;347/aug12_1/f4836</idno></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Objective To identify historical and clinical findings at emergency department presentation associated with severe H1N1 outcome in children presenting with influenza-like illness. Design Multicentre retrospective case-control study. Setting 79 emergency departments of hospitals associated with the Pediatric Emergency Research Networks in 12 countries. Participants 265 children (<16 years), presenting between 16 April and 31 December 2009, who fulfilled Centers for Disease Control and Prevention criteria for influenza-like illness and developed severe outcomes from laboratory confirmed H1N1 infection. For each case, two controls presenting with influenza-like illness but without severe outcomes were included: one random control and one age matched control. Main outcome measures Severe outcomes included death or admission to intensive care for assisted ventilation, inotropic support, or both. Multivariable conditional logistic regression was used to compare cases and controls, with effect sizes measured as adjusted odds ratios. Results 151 (57%) of the 265 cases were male, the median age was 6 (interquartile range 2.3-10.0) years, and 27 (10%) died. Six factors were associated with severe outcomes in children presenting with influenza-like illness: history of chronic lung disease (odds ratio 10.3, 95% confidence interval 1.5 to 69.8), history of cerebral palsy/developmental delay (10.2, 2.0 to 51.4), signs of chest retractions (9.6, 3.2 to 29.0), signs of dehydration (8.8, 1.6 to 49.3), requirement for oxygen (5.8, 2.0 to 16.2), and tachycardia relative to age). Conclusion These independent risk factors may alert clinicians to children at risk of severe outcomes when presenting with influenza-like illness during future pandemics.</div></front></TEI><affiliations><list><country><li>Australie</li><li>Canada</li><li>Israël</li><li>Nouvelle-Zélande</li><li>Pays-Bas</li><li>Portugal</li><li>États-Unis</li></country><region><li>Alberta</li><li>Californie</li><li>District de Columbia</li><li>Hollande-Septentrionale</li><li>Manitoba</li><li>Texas</li></region><settlement><li>Amsterdam</li><li>Calgary</li><li>Washington (district de Columbia)</li><li>Winnipeg</li></settlement><orgName><li>Université de Calgary</li><li>Université du Manitoba</li></orgName></list><tree><country name="Nouvelle-Zélande"><noRegion><name sortKey="Dalziel, Stuart R" sort="Dalziel, Stuart R" uniqKey="Dalziel S" first="Stuart R" last="Dalziel">Stuart R. Dalziel</name></noRegion><name sortKey="Dalziel, Stuart R" sort="Dalziel, Stuart R" uniqKey="Dalziel S" first="Stuart R" last="Dalziel">Stuart R. Dalziel</name><name sortKey="Dalziel, Stuart R" sort="Dalziel, Stuart R" uniqKey="Dalziel S" first="Stuart R" last="Dalziel">Stuart R. Dalziel</name><name sortKey="Thompson, John Md" sort="Thompson, John Md" uniqKey="Thompson J" first="John Md" last="Thompson">John Md Thompson</name></country><country name="États-Unis"><region name="Texas"><name sortKey="Macias, Charles G" sort="Macias, Charles G" uniqKey="Macias C" first="Charles G" last="Macias">Charles G. Macias</name></region><name sortKey="Chamberlain, James M" sort="Chamberlain, James M" uniqKey="Chamberlain J" first="James M" last="Chamberlain">James M. Chamberlain</name><name sortKey="Kuppermann, Nathan" sort="Kuppermann, Nathan" uniqKey="Kuppermann N" first="Nathan" last="Kuppermann">Nathan Kuppermann</name></country><country name="Portugal"><noRegion><name sortKey="Fernandes, Ricardo M" sort="Fernandes, Ricardo M" uniqKey="Fernandes R" first="Ricardo M" last="Fernandes">Ricardo M. Fernandes</name></noRegion></country><country name="Canada"><region name="Alberta"><name sortKey="Johnson, David W" sort="Johnson, David W" uniqKey="Johnson D" first="David W" last="Johnson">David W. Johnson</name></region><name sortKey="Black, Karen Jl" sort="Black, Karen Jl" uniqKey="Black K" first="Karen Jl" last="Black">Karen Jl Black</name><name sortKey="Fitzpatrick, Eleanor" sort="Fitzpatrick, Eleanor" uniqKey="Fitzpatrick E" first="Eleanor" last="Fitzpatrick">Eleanor Fitzpatrick</name><name sortKey="Klassen, Terry P" sort="Klassen, Terry P" uniqKey="Klassen T" first="Terry P" last="Klassen">Terry P. Klassen</name><name sortKey="Newton, Amanda S" sort="Newton, Amanda S" uniqKey="Newton A" first="Amanda S" last="Newton">Amanda S. Newton</name><name sortKey="Osmond, Martin H" sort="Osmond, Martin H" uniqKey="Osmond M" first="Martin H" last="Osmond">Martin H. Osmond</name><name sortKey="Plint, Amy" sort="Plint, Amy" uniqKey="Plint A" first="Amy" last="Plint">Amy Plint</name></country><country name="Israël"><noRegion><name sortKey="Waisman, Yehezkel" sort="Waisman, Yehezkel" uniqKey="Waisman Y" first="Yehezkel" last="Waisman">Yehezkel Waisman</name></noRegion></country><country name="Australie"><noRegion><name sortKey="Cheng, Nicholas" sort="Cheng, Nicholas" uniqKey="Cheng N" first="Nicholas" last="Cheng">Nicholas Cheng</name></noRegion><name sortKey="Acworth, Jason" sort="Acworth, Jason" uniqKey="Acworth J" first="Jason" last="Acworth">Jason Acworth</name></country><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="Valerio, Paolo" sort="Valerio, Paolo" uniqKey="Valerio P" first="Paolo" last="Valerio">Paolo Valerio</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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