Godoy Pere, Rodés Anna, Alvarez Josep, Camps Neus, Barrabeig Irene, Sala María Rosa, Minguell Sofía, Lafuente Sarah, Pumarola Tomás, Domínguez Angela, Plasència Antoni
Departamento de Salud, Generalidad de Cataluña, C/Alcalde Rovira Roure 2, Lleida.
Rev Esp Salud Publica. 2011 Jan-Feb;85(1):81-7. doi: 10.1590/S1135-57272011000100010.
Influenza pandemics may cause more severe cases. The objective was to determine the characteristics of hospitalized severe cases of pandemic influenza in Catalonia and to study risk factors for admission to intensive care unit (ICU).
A prospective epidemiologic study of new cases of pandemic influenza hospitalized by their severity between June 2009 and May 2010. Hospitals were asked to declare laboratory confirmed pandemic influenza cases that met the case specific case definition for severe case. A standardized epidemiological survey was conducted to collect information on demographics, clinical characteristics, risk factors, treatment and outcome. Differences between the cases in ICU compared to other severe cases were studied with the odds ratio (OR), which were adjusted using a logistic regression model.
We detected total of 773 pandemic influenza (H1N1) 2009 severe cases; 465 (60.2%) of them had at least one risk factor and the most prevalent were: pregnancy 19 (13%), asthma 87 (12%), chronic obstructive pulmonary disease 87 (11.4%) and heart disease 80 (10.5%). Required admission to ICU 293 patients (37.9%). Factors associated with ICU admission were obesity BMI>40 (adjusted OR = 2.5, 95% CI 1.4-4.5) and chronic liver disease (adjusted OR = 2.3, 95% CI 1.1-4.8).
This study confirms the high prevalence of pregnancy, chronic respiratory diseases, diabetes and obesity among pandemic influenza severe cases. Obesity acts as a risk factor for ICU admission and should therefore be considered as an indicator for influenza vaccination.
流感大流行可能导致更严重的病例。目的是确定加泰罗尼亚地区住院的大流行性流感重症病例的特征，并研究入住重症监护病房（ICU）的危险因素。
对2009年6月至2010年5月期间因病情严重程度住院的新型大流行性流感病例进行前瞻性流行病学研究。要求医院申报实验室确诊的符合重症病例特定病例定义的大流行性流感病例。进行标准化的流行病学调查，以收集有关人口统计学、临床特征、危险因素、治疗和结局的信息。使用比值比（OR）研究ICU病例与其他重症病例之间的差异，并通过逻辑回归模型进行调整。
我们共检测到773例2009年甲型H1N1流感重症病例；其中465例（60.2%）至少有一个危险因素，最常见的是：妊娠19例（13%）、哮喘87例（12%）、慢性阻塞性肺疾病87例（11.4%）和心脏病80例（10.5%）。293例患者（37.9%）需要入住ICU。与入住ICU相关的因素是肥胖（BMI>40）（调整后的OR=2.5，95%CI 1.4-4.5）和慢性肝病（调整后的OR=2.3，95%CI 1.1-4.8）。
本研究证实了大流行性流感重症病例中妊娠、慢性呼吸道疾病、糖尿病和肥胖的高患病率。肥胖是入住ICU的危险因素，因此应被视为流感疫苗接种的指标。
