Phung Hai, Beard Frank, Selvey Christine, Appuhamy Ranil, Birrell Frances
Communicable Diseases Branch, Queensland Health, Brisbane, Queensland, Australia . ; School of Public Health, Queensland University of Technology, Brisbane, Queensland, Australia .
Western Pac Surveill Response J. 2011 May 30;2(2):30-5. doi: 10.5365/WPSAR.2010.1.1.013. Print 2011 Apr.
To describe the demographic and clinical characteristics of patients hospitalized with pandemic A(H1N1) 2009 infection in Queensland, Australia between 25 May and 3 October 2009 and to examine the relationship between timing of antiviral treatment and severity of illness.
Using data from the Queensland Health EpiLog information system, descriptive analysis and logistic regression modelling were used to describe and model factors which influence patient outcomes (death, admission to intensive care unit and/or special care unit). Data on patients admitted to hospital in Queensland with confirmed pandemic A(H1N1) 2009 infection were included in this analysis.
1236 patients with pandemic A(H1N1) 2009 infection were admitted to hospitals in Queensland during the study period. Of the total group: 15% were admitted to an intensive care unit or special care unit; 3% died; 34% were under the age of 18 years and 8% were 65 years of age or older; and 55% had at least one underlying medical condition. Among the 842 patients for whom data were available regarding the use of antiviral drugs, antiviral treatment was initiated in 737 (87.5%) patients, treatment commenced at a median of one day (range 1-33 days) after onset of illness. Admission to an intensive care unit or special care unit (ICU/SCU) or death was significantly associated with increased age, lack of timeliness of antiviral treatment, chronic renal disease and morbid obesity.
Early antiviral treatment was significantly associated with lower likelihood of ICU/SCU admission or death. Early antiviral treatment for influenza cases may therefore have important public health implications.
描述2009年5月25日至10月3日期间澳大利亚昆士兰州因2009年甲型H1N1流感大流行感染而住院患者的人口统计学和临床特征，并研究抗病毒治疗时机与疾病严重程度之间的关系。
利用昆士兰卫生部EpiLog信息系统的数据，采用描述性分析和逻辑回归模型来描述和建模影响患者结局（死亡、入住重症监护病房和/或特殊护理病房）的因素。本分析纳入了昆士兰州确诊感染2009年甲型H1N1流感大流行的住院患者数据。
在研究期间，1236例2009年甲型H1N1流感大流行感染患者被收治到昆士兰州的医院。在整个组中：15%入住重症监护病房或特殊护理病房；3%死亡；34%年龄在18岁以下，8%年龄在65岁及以上；55%至少有一种基础疾病。在842例可获得抗病毒药物使用数据的患者中，737例（87.5%）开始了抗病毒治疗，治疗在发病后中位数为1天（范围1 - 33天）开始。入住重症监护病房或特殊护理病房（ICU/SCU）或死亡与年龄增加、抗病毒治疗不及时、慢性肾病和病态肥胖显著相关。
早期抗病毒治疗与入住ICU/SCU或死亡的可能性显著降低相关。因此，对流感病例进行早期抗病毒治疗可能具有重要的公共卫生意义。
