Pediatrics Department, Hospital Infanta Elena, Valdemoro, Madrid, Spain.
Influenza Other Respir Viruses. 2011 Nov;5(6):e544-51. doi: 10.1111/j.1750-2659.2011.00272.x. Epub 2011 Jul 22.
To describe the epidemiological and clinical characteristics of children hospitalized with 2009 pandemic influenza (pH1N1) in Madrid, Spain.
PATIENTS/METHODS: We included patients less than 14 years of age admitted to one of 18 hospitals in Madrid, Spain, between May 1 and November 30, 2009 and diagnosed with pH1N1 by polymerase chain reaction. A retrospective chart review was conducted and data were compared by age, presence of high-risk medical conditions, and pediatric intensive care unit (PICU) admission.
A total of 517 pH1N1 cases were included for final analysis. One hundred and forty-two patients (27·5%) had predisposing underlying illnesses, with immunosuppression (36 children, 7%) and moderate persistent asthma (34, 6·6%) being the most common ones. Patients with underlying medical conditions had longer hospital stays [median 5, interquartile range (IQR) 3-8 days, versus median 4, IQR 3-6, P < 0·001] and required intensive care (20·4% versus 5·9%, P < 0·001) and mechanical ventilation more frequently than previously healthy children. Globally, intensive care was required for 51 patients (10%) and invasive mechanical ventilation for 12 (2%). Pediatric intensive care unit admission was significantly associated with abnormal initial chest X-ray [Odds Ratio (OR) 3·5, 95% confidence interval (CI) 1·5-8·5], underlying neurological condition (OR 3·1, CI 1·2-7·5) and immunosuppression (OR 2·9, 1·2-6·8). Five patients (0·9%) died; two with severe neurological disease, two with leukemia, and one with a malignant solid tumor.
Children with underlying medical conditions experienced more severe pH1N1 disease. Risk factors for admission to the PICU included underlying neurological conditions, immunosuppression and abnormal initial chest X-ray.
描述西班牙马德里因 2009 年大流行性流感（pH1N1）住院的儿童的流行病学和临床特征。
患者/方法：我们纳入了 2009 年 5 月 1 日至 11 月 30 日期间在西班牙马德里的 18 家医院之一住院且通过聚合酶链反应诊断为 pH1N1 的 14 岁以下患者。进行了回顾性病历复查，并根据年龄、存在高危医疗条件和儿科重症监护病房（PICU）入院情况对数据进行了比较。
共纳入 517 例 pH1N1 病例进行最终分析。142 例患者（27.5%）存在潜在的基础疾病，其中免疫抑制（36 例，7%）和中度持续性哮喘（34 例，6.6%）最为常见。有基础疾病的患者住院时间更长[中位数 5 天，四分位距（IQR）3-8 天，中位数 4 天，IQR 3-6，P<0.001]，需要重症监护（20.4% 对 5.9%，P<0.001）和机械通气的频率也高于无基础疾病的儿童。总体而言，需要 51 名患者（10%）进行重症监护，12 名患者（2%）进行有创机械通气。儿科重症监护病房入院与初始胸部 X 线异常显著相关[比值比（OR）3.5，95%置信区间（CI）1.5-8.5]、基础神经系统疾病（OR 3.1，CI 1.2-7.5）和免疫抑制（OR 2.9，1.2-6.8）。5 例患者（0.9%）死亡；其中 2 例患有严重神经系统疾病，2 例患有白血病，1 例患有恶性实体瘤。
患有基础疾病的儿童经历了更严重的 pH1N1 疾病。入住儿科重症监护病房的危险因素包括基础神经系统疾病、免疫抑制和初始胸部 X 线异常。
