Prognostic factors for fatal adult influenza pneumonia

Ya Chi Ho, Jiun Ling Wang, Jann Tay Wang, Un In Wu, Chiu Wen Chang, Ho Sheng Wu, Chang Hsun Chen, Yu Min Chuang, Shan Chwen Chang

Research output: Contribution to journalArticlepeer-review

39 Citations (Scopus)

Abstract

Objectives: To elucidate the prognostic factors for fatal adult influenza pneumonia. Methods: Complicated influenza pneumonia is a notifiable disease in Taiwan. In this retrospective nationwide cohort, medical records were reviewed in 38 qualifying cases from 2001 to 2007. In-hospital mortality was the primary endpoint of this study. Results: The median patient age was 52 years, with the in-hospital mortality rate of 44.7%. Influenza A virus was found in 25 patients and influenza B was in 13 patients. Fifty percent of patients had no comorbidities. More than half of the patients developed sepsis, septic shock, respiratory failure or acute respiratory distress syndrome. The median duration from symptom onset to hospital visit was 3 days, and from hospital visit to death was 4 days. A univariate analysis demonstrated poor prognosis in patients with shock, respiratory rate ≥25/min, arterial pH < 7.35, creatinine ≥ 2 mg/dL and Pneumonia Severity Index IV or V. A multivariate analysis showed an association with mortality in patients with APACHE II score ≥20 (hazard ratio 5.941, p = 0.024) or PaO2/FiO2 ratio <150 (hazard ratio 4.194, p = 0.017). Conclusions: Clinical knowledge of identified prognostic factors for mortality may aid management of adult influenza pneumonia.

Original languageEnglish
Pages (from-to)439-445
Number of pages7
JournalJournal of Infection
Volume58
Issue number6
DOIs
Publication statusPublished - 2009 Jun

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

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