title: Descriptive Analysis of Mortality Predictors in H1n1 Influenza in South Indian Patients.
abstract: BACKGROUND
  H1N1 (hemagglutinin-H-neuroaminidase-N) influenza infection is associated with high morbidity and mortality because of associated complications and related factors. Predictors of mortality in H1N1 patients are studied with very few without seasonal/pandemic declaration. This study was carried out to describe the clinical features, complications and different risk factors that affect the outcome in the patients with confirmed H1N1influenza infection.
  
  
  METHODS
  A retrospective study was done in Kasturba Medical College Hospital, Manipal, India by analyzing the medical records of 141 patients admitted from January, 2011 to June, 2015.
  
  
  RESULTS
  Of the 141 patients in the study, 51.1% of the patients were female with a mean age of 32±16.2 years. Fever with headache was observed in 92.9% patients while cough in 78.7% patients and breathlessness in 54.6% patients. On the basis of disease severity, 53.2% of the patients were put on mechanical ventilation. For all the patients, treatment for influenza management began with oseltemivir. Diuretics, antianxiety and corticosteroids were given as supportive and symptomatic care which contributed to high mortality in hospitalized patients. Mean hospitalization period was 8.5 days. During the hospitalization, patients developed different complications i.e. 31.20% patients developed respiratory tract infections, while 17.7% patients developed ARDS and 14.4% patients developed sepsis. The mortality rate of this study population was found to be 29.1 %.
  
  
  CONCLUSIONS
  It was observed that low oxygen saturation during admission, high blood urea level, use of diuretics, corticosteroids, anti-anxiety drugs and complications like ARDS, sepsis influence the mortality rate of patients with H1N1 infection.
authors.affiliation: Department of Cardiology, Kasturba Medical College & Hospital, Manipal University, Manipal-576104, India.
authors.forename: Ajit
authors.initials: A
authors.lastname: Singh
authors.affiliation: Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal-576104, India.
authors.forename: Kanav
authors.initials: K
authors.lastname: Khera
authors.affiliation: Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal-576104, India.
authors.forename: Jatin
authors.initials: J
authors.lastname: Agarwal
authors.affiliation: Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal-576104, India.
authors.forename: Shivanshu
authors.initials: S
authors.lastname: Awasthi
authors.affiliation: Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal-576104, India.
authors.forename: Jewel M
authors.initials: JM
authors.lastname: Francis
authors.affiliation: Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal-576104, India.
authors.forename: Girish
authors.initials: G
authors.lastname: Thunga
authors.affiliation: Department of General Medicine, Kasturba Medical College and Hospital, Manipal University, Manipal-576104, India.
authors.forename: Rama
authors.initials: R
authors.lastname: Bhat
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007194:India / Q000453:epidemiology; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification / Q000502:physiology; D007251:Influenza, Human / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D007362:Intensive Care Units; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000453:epidemiology / Q000821:virology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents
keywords: Swine flu; acute respiratory distress syndrome; corticosteroids; multiple organs dysfunction syndrome; viral
  infection in India