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韩国甲型 H1N1 流感大流行期间危重症成年患者的流行病学分析。

Epidemiological analysis of critically ill adult patients with pandemic influenza A(H1N1) in South Korea.

机构信息

Ulsan University College of Medicine, Seoul, Korea.

出版信息

Epidemiol Infect. 2013 May;141(5):1070-9. doi: 10.1017/S0950268812001604. Epub 2012 Aug 1.

Abstract

A total of 245 patients with confirmed 2009 H1N1 influenza were admitted to the intensive-care units of 28 hospitals (South Korea). Their mean age was 55.3 years with 68.6% aged >50 years, and 54.7% male. Nine were obese and three were pregnant. One or more comorbidities were present in 83.7%, and nosocomial acquisition occurred in 14.3%. In total, 107 (43.7%) patients received corticosteroids and 66.1% required mechanical ventilation. Eighty (32.7%) patients died within 30 days after onset of symptoms and 99 (40.4%) within 90 days. Multivariate logistic regression analysis showed that the clinician's decision to prescribe corticosteroids, older age, Sequential Organ Failure Assessment score and nosocomial bacterial pneumonia were independent risk factors for 90-day mortality. In contrast with Western countries, critical illness in Korea in relation to 2009 H1N1 was most common in older patients with chronic comorbidities; nosocomial acquisition occurred occasionally but disease in obese or pregnant patients was uncommon.

摘要

共有 245 名确诊为 2009 年 H1N1 流感的患者被收入韩国 28 家医院的重症监护病房。他们的平均年龄为 55.3 岁,其中 68.6%的年龄大于 50 岁,54.7%为男性。9 人肥胖,3 人怀孕。83.7%的患者存在一种或多种合并症,14.3%的患者发生医院获得性感染。共有 107 例(43.7%)患者接受了皮质类固醇治疗,66.1%的患者需要机械通气。80 例(32.7%)患者在症状出现后 30 天内死亡,99 例(40.4%)在 90 天内死亡。多变量逻辑回归分析表明,临床医生决定使用皮质类固醇、年龄较大、序贯器官衰竭评估评分和医院获得性细菌性肺炎是 90 天死亡率的独立危险因素。与西方国家不同,韩国与 2009 年 H1N1 相关的重症疾病最常见于患有慢性合并症的老年患者;医院获得性感染偶尔发生,但肥胖或怀孕患者的疾病并不常见。

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