King Saud Medical Complex, Riyadh, Saudi Arabia.
J Infect Public Health. 2012 Mar;5(1):52-6. doi: 10.1016/j.jiph.2011.10.005. Epub 2011 Dec 14.
The objective of this study was to describe the epidemiological characteristics, clinical features, treatment, and outcome of 2009 H1N1-infected patients who were admitted to the intensive care unit (ICU) at King Saud Medical City (KSMC) in Riyadh, Kingdom of Saudi Arabia.
Retrospectively, we collected demographic data as well as data on the clinical presentation and risk factors for 86 patients who were admitted to the ICU with H1N1 influenza A. The APACHE IV System was used to assess the severity of the illness. The overall hospital mortality was calculated and correlated with the use of steroids and the time of oseltamivir administration.
The mean age of the patients was 40.8 years. Mortality increased steadily with increasing APACHE IV score. Patients who received steroids had a mortality rate of 47% compared with 23% for patients who were not treated with steroids; this difference was significant, with a P value of <0.01. The late administration of oseltamivir was associated with a mortality rate of 82% compared with 28% in the context of early oseltamivir administration; this difference was significant, with a P value of <0.01.
Patients who were admitted to the ICU with severe 2009 H1N1 infection were young and had a relatively high severity-of-illness score. The late administration of oseltamivir was associated with a 12-fold increase in mortality. Steroid use was associated with a 3-fold increase in mortality.
本研究旨在描述沙特阿拉伯利雅得 King Saud 医疗城（KSMC）重症监护病房（ICU）收治的 2009 年 H1N1 感染患者的流行病学特征、临床特征、治疗和转归。
我们回顾性收集了 86 例 ICU 收治的 H1N1 流感 A 患者的人口统计学数据、临床特征和危险因素。采用 APACHE IV 系统评估疾病严重程度。计算了总体住院死亡率，并与激素使用和奥司他韦给药时间相关联。
患者的平均年龄为 40.8 岁。死亡率随 APACHE IV 评分的增加而稳步上升。接受激素治疗的患者死亡率为 47%，而未接受激素治疗的患者死亡率为 23%；差异具有统计学意义，P 值<0.01。奥司他韦延迟给药与死亡率为 82%相关，而早期奥司他韦给药的死亡率为 28%；差异具有统计学意义，P 值<0.01。
因严重 2009 年 H1N1 感染而入住 ICU 的患者年龄较轻，疾病严重程度评分相对较高。奥司他韦延迟给药与死亡率增加 12 倍相关。激素使用与死亡率增加 3 倍相关。
