title: Clinical characteristics and outcome of patients with pandemic 2009 Influenza A(H1N1)v virus infection admitted to hospitals with different levels of health-care.
abstract: BACKGROUND
  The outcome of patients with influenza A 2009 (H1N1)v virus infection taking into account hospital type has not been elucidated.
  
  
  OBJECTIVE
  To compare risk factors, clinical features and outcome of patients admitted to 3 public hospitals with different levels of health-care.
  
  
  METHODS
  Prospective study of all non-pregnant adult patients admitted to 3 hospitals with pandemic H1N1 infection, from June 1 to December 31 and followed up until 1 month after discharge.
  
  
  RESULTS
  During the study period, 111 patients with a mean age of 49 years (15-89) were hospitalized: 52 in hospital 1 (900-bed tertiary-teaching-hospital), 33 in hospital 2 (315-beds secondary-hospital) and 26 in hospital 3 (150-beds primary-care-hospital).Overall 80% of patients had at least 1 comorbid condition with no differences between hospitals. Symptoms or signs on admission were similar except for cough (P=0.01) more frequent in patients in hospital 1 and dyspnea (P=0.05), myalgia, arthralgia (P=0.04) and hypoxemia (P=0.009) present in more patients in hospital 2. In-hospital mortality rates were not statistically different between hospitals. In the stepwise analysis, independent predictors of mortality were pneumonia on admission (adjusted OR=8.68, 95%CI 1.0-82.43) and cardiac complications during hospitalization (adjusted OR=13.2, 95%CI 1.67-103.98).
  
  
  CONCLUSIONS
  Mortality of patients with pandemic H1N1 infection was influenced by patients underlying conditions, severity of disease (pneumonia) on admission and complications during hospitalization. Hospital-characteristics do not appear to have influenced severe outcome.
authors.affiliation: Infectious Diseases Unit, Hospital Marqués de Valdecilla, University of Cantabria, Santander.
authors.forename: Manuel
authors.initials: M
authors.lastname: Gutiérrez-Cuadra
authors.forename: José Luis
authors.initials: JL
authors.lastname: González-Fernández
authors.forename: Paz
authors.initials: P
authors.lastname: Rodríguez-Cundin
authors.forename: Concepción
authors.initials: C
authors.lastname: Fariñas-Álvarez
authors.forename: María Victoria
authors.initials: MV
authors.lastname: San Juan
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Parra
authors.forename: Miguel
authors.initials: M
authors.lastname: Carrascosa
authors.forename: María Carmen
authors.initials: MC
authors.lastname: Fariñas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D015331:Cohort Studies; D015897:Comorbidity; D003625:Data Collection; D004196:Disease Outbreaks; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D053139:Oseltamivir / Q000627:therapeutic use; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012121:Respiration, Artificial; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir