Outcome of critically ill patients with influenza virus infection.
BACKGROUND
Influenza is a major cause of morbidity and mortality, with its greatest burden on the elderly and patients with chronic co-morbidities in the intensive care unit (ICU). An accurate prognosis is essential for decision-making during pandemic as well as interpandemic periods.


METHODS
A retrospective cohort study was conducted to determine prognostic factors influencing short term outcome of critically ill patients with confirmed influenza virus infection. Baseline characteristics, laboratory and diagnostic findings, ICU interventions and complications were abstracted from medical records using standard definitions and compared between hospital survivors and non-survivors with univariate and multivariate logistic regression analyses.


RESULTS
111 patients met the inclusion criteria. Acute respiratory distress syndrome (ARDS) complicated ICU course in 25 (23%) of the patients, with mortality rate of 52%. Multivariate logistic regression analysis identified the following predictors of hospital mortality: Acute Physiology and Chronic Health Evaluation (APACHE) III predicted mortality (Odds ratio [OR] 1.49, 95% confidence interval [CI] 1.1-2.1 for 10% increase), ARDS (OR 7.7, 95% CI 2.3-29) and history of immunosuppression (OR 7.19, 95% CI 1.9-28).


CONCLUSIONS
APACHE III predicted mortality, the development of ARDS and the history of immunosuppression are independent risk factors for hospital mortality in critically ill patients with confirmed influenza virus infection.
Li
Guangxi
G
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, United States.
Yilmaz
Murat
M
Kojicic
Marija
M
Fernández-Pérez
Evans
E
Wahab
Raed
R
Huskins
W Charles
WC
Afessa
Bekele
B
Truwit
Jonathon D
JD
Gajic
Ognjen
O
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016638:Critical Illness; D005260:Female; D006801:Humans; D007251:Influenza, Human / Q000150:complications / Q000473:pathology* / Q000628:therapy; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000628:therapy / Q000821:virology*; D012189:Retrospective Studies
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