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Factors associated with death or intensive care unit admission due to pandemic 2009 influenza A (H1N1) infection
Payam Tabarsi1, Ahmadreza Moradi2, Majid Marjani1, Parvaneh Baghaei1, Seyed Mohammadreza Hashemian3, Seyed Alireza Nadji3, Atefeh Fakharian4, Davood Mansouri4, Mohammadreza Masjedi5, Aliakbar Velayati6
1 Virology Research Center, NRITLD, Masih-Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Virology Research Center; Nursing and Respiratory Health Management Research Center, NRITLD, Masih-Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Nursing and Respiratory Health Management Research Center, NRITLD, Masih-Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Masih-Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 Chronic Respiratory Disease Research Center, NRITLD, Masih-Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
6 Pediatric Respiratory Disease Research Center, NRITLD, Masih-Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Correspondence Address:
Ahmadreza Moradi
Virology Research Center, NRITLD, Masih-Daneshvari Hospital, Darabad, Shahid Bahonar Ave., Tehran
Iran
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1817-1737.78429
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Background : In preparation for pandemic H1N1 or H1N1 influenza (H1N1) it is necessary to identify factors associated with mortality of patients with H1N1 and hospital admissions to intensive care unit (ICU) of patients diagnosed in 2009 with H1N1.
Objectives : To describe the clinical and epidemiological features associated with 2009 H1N1 mortality and ICU patient admissions to Masih Daneshvari Teaching Hospital, Iran.
Methods : A retrospective cross-sectional study was conducted among patients with mortality and admissions to ICU with confirmed H1N1. Demographic, clinical, laboratory, radiological findings, and epidemiologic data were abstracted from medical records, using a standardized datasheet.
Results : From June through December 2009, 20 out of the 46 confirmed hospitalized patients with confirmed H1N1 were admitted to the ICU and 7 (15%) died. Among various variables, opium inhalation (P = 0.01), having productive cough, hemoptysis, chest pain, confusion, and loss of consciousness were significantly related to ICU admission (P < 0.05). Pleural effusion (P = 0.006), elevated liver enzymes, as well as CPK and LDH level were significantly relevant to ICU admission (P < 0.05). Delayed antiviral treatment was more common among patients who died and the elderly.
Discussion : Patients who were admitted to ICU with confirmed H1N1 included the following risk factors: delayed initiation of antiviral therapy, history of opium inhalation and symptoms including; productive cough, hemoptysis, chest pain, confusion, and loss of consciousness. The mortality rate in the study population was high but compares favorably with other recent published studies. |
