Predictive factors for mortality among in-hospital Mexican patients infected with influenzaA/H1N1
Abstract number: P1096
Mata-Marin J.A., Ascencio-Montiel I., Gaytan-Martinez J.E., Arias-Flores R., Martinez-Chacon C.
Objective: To determine predictive factors for mortality among in-hospital Mexican patients infected with influenza A/H1N1.
Methods: We performed a casecontrol study of the factors associated with unfavorable prognosis (mortality) among inpatients with documented influenza A/H1N1 infection. We enrolled patients seen from April to October 2009 at the Hospital de Infectologia, La Raza National Medical Center, in Mexico City. Cases were those patients who die during the hospitalization and controls were those who were discharged due to improvement. Patients were included if they had over 18 years old and a positive influenza A/H1N1 RT-PCR test. Data collected included, general attributes, medical history, presenting symptoms, records about respiratory evolution, and routine laboratory tests.
We compared median differences using t test or MannWhitney U test when data were skewed. Odds ratio and 95% confidence interval were calculated to assess the relationship between each predictive factor and the risk of mortality. To adjust for the effects of potential confounders, we used a logistic regression models. P-value was considering statistically significant if <0.05.
Results: We included 31 patients (11 cases and 20 controls), of the patients enrolled 12 (38.7%) were male: 7 (63.6%) in cases group and 5 (25%) in controls group. The median (±SD) age of our subjects was 36.2±13.8 and 34.25±11.47 respectively (p = 0.685).
The risk factors associated to mortality were: male sex OR 5.25 (CI 95% 1.0725.79), delayed in medical attention (>3 days) OR 6.41 (95% CI 1.1834.61), delayed to start anti-flu therapy (>3 days) OR 10.0 (95% CI 1.0793.43), admission to the intensive care unit OR 9.9, (95% CI 1.5164.52), required mechanical ventilation OR 9.3 (CI 95% 1.4361.14), presence of chronic diseases OR 10.86 (CI 95% 1.02114.57), and high creatinine levels (>1.0 mg/dl) at admission to hospital OR 11.2 (95% CI 1.05120.32). After adjust for the effects of potential confounders in a logistic regression model, we found only delayed in medical attention aOR 22.68 (p = 0.02) and presence of chronic diseases aOR 47.62 (p = 0.037) as predictors of mortality.
Conclusion: An early medical attention is necessary to decrease mortality in patients with influenza A/H1N1. Presence of chronic diseases increased the possibility of mortality in in-patients with influenza A/H1N1 in Mexican population.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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