Risk factors of A/H1N1 etiology in pneumonia and its impact on mortality.
Identifieur interne : 000383 ( Main/Exploration ); précédent : 000382; suivant : 000384Risk factors of A/H1N1 etiology in pneumonia and its impact on mortality.
Auteurs : S. Reyes [Espagne] ; B. Montull ; R. Martínez ; J. C Rdoba ; J M Molina ; V. Martí ; A. Martínez ; P. Ramírez ; R. MenéndezSource :
- Respiratory medicine [ 1532-3064 ] ; 2011.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Espagne (épidémiologie), Facteurs de risque (MeSH), Femelle (MeSH), Grippe humaine (mortalité), Grippe humaine (virologie), Hospitalisation (statistiques et données numériques), Humains (MeSH), Mortalité hospitalière (MeSH), Mâle (MeSH), Odds ratio (MeSH), Pandémies (MeSH), Pneumopathie virale (complications), Pneumopathie virale (mortalité), Pneumopathie virale (virologie), Protéine C-réactive (MeSH), Sous-type H1N1 du virus de la grippe A (isolement et purification), Sujet âgé (MeSH), Études rétrospectives (MeSH).
- MESH :
- isolement et purification : Sous-type H1N1 du virus de la grippe A.
- mortalité : Grippe humaine, Pneumopathie virale.
- statistiques et données numériques : Hospitalisation.
- virologie : Grippe humaine, Pneumopathie virale.
- épidémiologie : Espagne, Pneumopathie virale.
- Adulte, Adulte d'âge moyen, Facteurs de risque, Femelle, Humains, Mortalité hospitalière, Mâle, Odds ratio, Pandémies, Protéine C-réactive, Sujet âgé, Études rétrospectives.
- Wicri :
- geographic : Espagne.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), C-Reactive Protein (MeSH), Female (MeSH), Hospital Mortality (MeSH), Hospitalization (statistics & numerical data), Humans (MeSH), Influenza A Virus, H1N1 Subtype (isolation & purification), Influenza, Human (mortality), Influenza, Human (virology), Male (MeSH), Middle Aged (MeSH), Odds Ratio (MeSH), Pandemics (MeSH), Pneumonia, Viral (complications), Pneumonia, Viral (mortality), Pneumonia, Viral (virology), Retrospective Studies (MeSH), Risk Factors (MeSH), Spain (epidemiology).
- MESH :
- chemical : C-Reactive Protein.
- geographic , epidemiology : Spain.
- complications : Pneumonia, Viral.
- isolation & purification : Influenza A Virus, H1N1 Subtype.
- mortality : Influenza, Human, Pneumonia, Viral.
- statistics & numerical data : Hospitalization.
- virology : Influenza, Human, Pneumonia, Viral.
- Adult, Aged, Female, Hospital Mortality, Humans, Male, Middle Aged, Odds Ratio, Pandemics, Retrospective Studies, Risk Factors.
Abstract
OBJECTIVE
Pandemic flu has changed the epidemiology of pneumonia, thus challenging the prediction of etiology and outcome. We analyze the risk factors to predict influenza A/H1N1 infection in patients with pneumonia, and the impact of this etiology on mortality during a pandemic period. Differences between pneumonia with or without A/H1N1 coinfection are described.
METHODS
Retrospective observational study in 364 consecutive patients hospitalized with pneumonia during the A/H1N1 pandemic flu, April-December 2009.
RESULTS
294 patients (80.5%) had A/H1N1(-) pneumonia, 47 (13.2%) A/H1N1(+) pneumonia, and 23 (6.3%) coinfection. Mortality during hospitalization was 24/294 (8.2%), 8/47 (16.7%), 2/23 (8.7%) respectively. A regression logistic analysis (Area under curve, AUC 0.81) to predict A/H1N1(+) pneumonia identified four independent variables: age < 60 years (Odds ratio, OR 5.9), multilobar infiltrates (OR 7.7), C-reactive protein (CRP) < 10 mg/dL (OR 2.8), and leukopenia < 5000/mm(3) (OR 3.4). Risk factors for in-hospital mortality in the whole group were A/H1N1 (+) etiology and LDH > 600 IU/L (OR 4.1) when adjusting for PSI, and hypoxemia (OR 4.2) when adjusting for CURB 65 (AUC 0.81). Heart disease (OR 27.4) and LDH > 600 IU/L (OR 10.5) were risk factors for in-hospital mortality in A/H1N1(+) patients (AUC 0.81)
CONCLUSION
Leukopenia, multilobar infiltrates, CRP<10 mg/dl and age < 60 years were independently associated with A/H1N1(+) etiology. Pandemic A/H1N1(+) increased mortality pneumonia. Heart disease and LDH > 600 were independently associated with mortality in A/H1N1(+) pneumonia.
DOI: 10.1016/j.rmed.2011.04.011
PubMed: 21561754
Affiliations:
Links toward previous steps (curation, corpus...)
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C Rdoba</name></author><author><name sortKey="Molina, J M" sort="Molina, J M" uniqKey="Molina J" first="J M" last="Molina">J M Molina</name></author><author><name sortKey="Marti, V" sort="Marti, V" uniqKey="Marti V" first="V" last="Martí">V. Martí</name></author><author><name sortKey="Martinez, A" sort="Martinez, A" uniqKey="Martinez A" first="A" last="Martínez">A. Martínez</name></author><author><name sortKey="Ramirez, P" sort="Ramirez, P" uniqKey="Ramirez P" first="P" last="Ramírez">P. Ramírez</name></author><author><name sortKey="Menendez, R" sort="Menendez, R" uniqKey="Menendez R" first="R" last="Menéndez">R. Menéndez</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2011">2011</date><idno type="RBID">pubmed:21561754</idno><idno type="pmid">21561754</idno><idno type="doi">10.1016/j.rmed.2011.04.011</idno><idno type="wicri:Area/Main/Corpus">00375</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">00375</idno><idno type="wicri:Area/Main/Curation">000375</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000375</idno><idno type="wicri:Area/Main/Exploration">000375</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Risk factors of A/H1N1 etiology in pneumonia and its impact on mortality.</title><author><name sortKey="Reyes, S" sort="Reyes, S" uniqKey="Reyes S" first="S" last="Reyes">S. Reyes</name><affiliation wicri:level="1"><nlm:affiliation>Service of Pneumology, Hospital Universitario y Politécnico La Fe, Valencia, Spain. reyes@comv.es</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Service of Pneumology, Hospital Universitario y Politécnico La Fe, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Montull, B" sort="Montull, B" uniqKey="Montull B" first="B" last="Montull">B. Montull</name></author><author><name sortKey="Martinez, R" sort="Martinez, R" uniqKey="Martinez R" first="R" last="Martínez">R. Martínez</name></author><author><name sortKey="C Rdoba, J" sort="C Rdoba, J" uniqKey="C Rdoba J" first="J" last="C Rdoba">J. C Rdoba</name></author><author><name sortKey="Molina, J M" sort="Molina, J M" uniqKey="Molina J" first="J M" last="Molina">J M Molina</name></author><author><name sortKey="Marti, V" sort="Marti, V" uniqKey="Marti V" first="V" last="Martí">V. Martí</name></author><author><name sortKey="Martinez, A" sort="Martinez, A" uniqKey="Martinez A" first="A" last="Martínez">A. Martínez</name></author><author><name sortKey="Ramirez, P" sort="Ramirez, P" uniqKey="Ramirez P" first="P" last="Ramírez">P. Ramírez</name></author><author><name sortKey="Menendez, R" sort="Menendez, R" uniqKey="Menendez R" first="R" last="Menéndez">R. 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We analyze the risk factors to predict influenza A/H1N1 infection in patients with pneumonia, and the impact of this etiology on mortality during a pandemic period. Differences between pneumonia with or without A/H1N1 coinfection are described.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Retrospective observational study in 364 consecutive patients hospitalized with pneumonia during the A/H1N1 pandemic flu, April-December 2009.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>294 patients (80.5%) had A/H1N1(-) pneumonia, 47 (13.2%) A/H1N1(+) pneumonia, and 23 (6.3%) coinfection. Mortality during hospitalization was 24/294 (8.2%), 8/47 (16.7%), 2/23 (8.7%) respectively. A regression logistic analysis (Area under curve, AUC 0.81) to predict A/H1N1(+) pneumonia identified four independent variables: age < 60 years (Odds ratio, OR 5.9), multilobar infiltrates (OR 7.7), C-reactive protein (CRP) < 10 mg/dL (OR 2.8), and leukopenia < 5000/mm(3) (OR 3.4). Risk factors for in-hospital mortality in the whole group were A/H1N1 (+) etiology and LDH > 600 IU/L (OR 4.1) when adjusting for PSI, and hypoxemia (OR 4.2) when adjusting for CURB 65 (AUC 0.81). Heart disease (OR 27.4) and LDH > 600 IU/L (OR 10.5) were risk factors for in-hospital mortality in A/H1N1(+) patients (AUC 0.81)</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Leukopenia, multilobar infiltrates, CRP<10 mg/dl and age < 60 years were independently associated with A/H1N1(+) etiology. Pandemic A/H1N1(+) increased mortality pneumonia. Heart disease and LDH > 600 were independently associated with mortality in A/H1N1(+) pneumonia.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">21561754</PMID><DateCompleted><Year>2011</Year><Month>11</Month><Day>14</Day></DateCompleted><DateRevised><Year>2011</Year><Month>07</Month><Day>18</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1532-3064</ISSN><JournalIssue CitedMedium="Internet"><Volume>105</Volume><Issue>9</Issue><PubDate><Year>2011</Year><Month>Sep</Month></PubDate></JournalIssue><Title>Respiratory medicine</Title><ISOAbbreviation>Respir Med</ISOAbbreviation></Journal><ArticleTitle>Risk factors of A/H1N1 etiology in pneumonia and its impact on mortality.</ArticleTitle><Pagination><MedlinePgn>1404-11</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.rmed.2011.04.011</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">Pandemic flu has changed the epidemiology of pneumonia, thus challenging the prediction of etiology and outcome. We analyze the risk factors to predict influenza A/H1N1 infection in patients with pneumonia, and the impact of this etiology on mortality during a pandemic period. Differences between pneumonia with or without A/H1N1 coinfection are described.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Retrospective observational study in 364 consecutive patients hospitalized with pneumonia during the A/H1N1 pandemic flu, April-December 2009.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">294 patients (80.5%) had A/H1N1(-) pneumonia, 47 (13.2%) A/H1N1(+) pneumonia, and 23 (6.3%) coinfection. Mortality during hospitalization was 24/294 (8.2%), 8/47 (16.7%), 2/23 (8.7%) respectively. A regression logistic analysis (Area under curve, AUC 0.81) to predict A/H1N1(+) pneumonia identified four independent variables: age < 60 years (Odds ratio, OR 5.9), multilobar infiltrates (OR 7.7), C-reactive protein (CRP) < 10 mg/dL (OR 2.8), and leukopenia < 5000/mm(3) (OR 3.4). Risk factors for in-hospital mortality in the whole group were A/H1N1 (+) etiology and LDH > 600 IU/L (OR 4.1) when adjusting for PSI, and hypoxemia (OR 4.2) when adjusting for CURB 65 (AUC 0.81). Heart disease (OR 27.4) and LDH > 600 IU/L (OR 10.5) were risk factors for in-hospital mortality in A/H1N1(+) patients (AUC 0.81)</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Leukopenia, multilobar infiltrates, CRP<10 mg/dl and age < 60 years were independently associated with A/H1N1(+) etiology. Pandemic A/H1N1(+) increased mortality pneumonia. Heart disease and LDH > 600 were independently associated with mortality in A/H1N1(+) pneumonia.</AbstractText><CopyrightInformation>Copyright © 2011 Elsevier Ltd. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Reyes</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Service of Pneumology, Hospital Universitario y Politécnico La Fe, Valencia, Spain. reyes@comv.es</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Montull</LastName><ForeName>B</ForeName><Initials>B</Initials></Author><Author ValidYN="Y"><LastName>Martínez</LastName><ForeName>R</ForeName><Initials>R</Initials></Author><Author ValidYN="Y"><LastName>Córdoba</LastName><ForeName>J</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Molina</LastName><ForeName>J M</ForeName><Initials>JM</Initials></Author><Author ValidYN="Y"><LastName>Martí</LastName><ForeName>V</ForeName><Initials>V</Initials></Author><Author ValidYN="Y"><LastName>Martínez</LastName><ForeName>A</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Ramírez</LastName><ForeName>P</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Menéndez</LastName><ForeName>R</ForeName><Initials>R</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2011</Year><Month>05</Month><Day>10</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Respir Med</MedlineTA><NlmUniqueID>8908438</NlmUniqueID><ISSNLinking>0954-6111</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>9007-41-4</RegistryNumber><NameOfSubstance UI="D002097">C-Reactive Protein</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002097" MajorTopicYN="N">C-Reactive Protein</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017052" MajorTopicYN="N">Hospital Mortality</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006760" MajorTopicYN="N">Hospitalization</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D053118" MajorTopicYN="N">Influenza A Virus, H1N1 Subtype</DescriptorName><QualifierName UI="Q000302" MajorTopicYN="Y">isolation & purification</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName><QualifierName UI="Q000821" MajorTopicYN="Y">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016017" MajorTopicYN="N">Odds Ratio</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013030" MajorTopicYN="N" Type="Geographic">Spain</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2011</Year><Month>01</Month><Day>20</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2011</Year><Month>04</Month><Day>11</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2011</Year><Month>04</Month><Day>15</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2011</Year><Month>5</Month><Day>13</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2011</Year><Month>5</Month><Day>13</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2011</Year><Month>11</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">21561754</ArticleId><ArticleId IdType="pii">S0954-6111(11)00139-9</ArticleId><ArticleId IdType="doi">10.1016/j.rmed.2011.04.011</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Espagne</li></country></list><tree><noCountry><name sortKey="C Rdoba, J" sort="C Rdoba, J" uniqKey="C Rdoba J" first="J" last="C Rdoba">J. C Rdoba</name><name sortKey="Marti, V" sort="Marti, V" uniqKey="Marti V" first="V" last="Martí">V. Martí</name><name sortKey="Martinez, A" sort="Martinez, A" uniqKey="Martinez A" first="A" last="Martínez">A. Martínez</name><name sortKey="Martinez, R" sort="Martinez, R" uniqKey="Martinez R" first="R" last="Martínez">R. Martínez</name><name sortKey="Menendez, R" sort="Menendez, R" uniqKey="Menendez R" first="R" last="Menéndez">R. Menéndez</name><name sortKey="Molina, J M" sort="Molina, J M" uniqKey="Molina J" first="J M" last="Molina">J M Molina</name><name sortKey="Montull, B" sort="Montull, B" uniqKey="Montull B" first="B" last="Montull">B. Montull</name><name sortKey="Ramirez, P" sort="Ramirez, P" uniqKey="Ramirez P" first="P" last="Ramírez">P. Ramírez</name></noCountry><country name="Espagne"><noRegion><name sortKey="Reyes, S" sort="Reyes, S" uniqKey="Reyes S" first="S" last="Reyes">S. 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