Ministry of Health, Bucharest, Romania.
Influenza Other Respir Viruses. 2014 Jan;8(1):8-12. doi: 10.1111/irv.12209. Epub 2013 Nov 20.
Limited data are available from Central and Eastern Europe on risk factors for severe complications of influenza. Such data are essential to prioritize prevention and treatment resources and to adapt influenza vaccination recommendations.
To use sentinel surveillance data to identify risk factors for fatal outcomes among hospitalized patients with severe acute respiratory infections (SARI) and among hospitalized patients with laboratory-confirmed influenza.
Retrospective analysis of case-based surveillance data collected from sentinel hospitals in Romania during the 2009/2010 and 2010/2011 winter influenza seasons was performed to evaluate risk factors for fatal outcomes using multivariate logistic regression.
During 2009/2010 and 2010/2011, sentinel hospitals reported 661 SARI patients of which 230 (35%) tested positive for influenza. In the multivariate analyses, infection with influenza A(H1N1)pdm09 was the strongest risk factor for death among hospitalized SARI patients (OR: 6·6; 95% CI: 3·3-13·1). Among patients positive for influenza A(H1N1)pdm09 virus infection (n = 148), being pregnant (OR: 7·1; 95% CI: 1·6-31·2), clinically obese (OR: 2·9;95% CI: 1·6-31·2), and having an immunocompromising condition (OR: 3·7;95% CI: 1·1-13·4) were significantly associated with fatal outcomes.
These findings are consistent with several other investigations of risk factors associated with influenza A(H1N1)pdm09 virus infections. They also support the more recent 2012 recommendations by the WHO Strategic Advisory Group of Experts on Immunization (SAGE) that pregnant women are an important risk group for influenza vaccination. Ongoing sentinel surveillance can be useful tool to monitor risk factors for complications of influenza virus infections during each influenza season, and pandemics as well.
中东欧国家有关流感严重并发症的危险因素的数据有限。这些数据对于确定预防和治疗资源的优先次序以及调整流感疫苗接种建议至关重要。
利用哨点监测数据，确定严重急性呼吸道感染（SARI）住院患者和实验室确诊流感住院患者的死亡结局的危险因素。
对罗马尼亚哨点医院在 2009/2010 年和 2010/2011 年冬季流感季节收集的基于病例的监测数据进行回顾性分析，采用多变量逻辑回归评估死亡结局的危险因素。
2009/2010 年和 2010/2011 年期间，哨点医院报告了 661 例 SARI 患者，其中 230 例（35%）流感检测呈阳性。在多变量分析中，感染甲型 H1N1pdm09 是住院 SARI 患者死亡的最强危险因素（OR：6.6；95%CI：3.3-13.1）。在感染甲型 H1N1pdm09 病毒的患者中（n=148），妊娠（OR：7.1；95%CI：1.6-31.2）、临床肥胖（OR：2.9；95%CI：1.6-31.2）和免疫功能低下（OR：3.7；95%CI：1.1-13.4）与死亡结局显著相关。
这些发现与其他几项关于甲型 H1N1pdm09 病毒感染相关危险因素的研究一致。它们还支持世界卫生组织免疫战略咨询专家组（SAGE）在 2012 年的最新建议，即孕妇是流感疫苗接种的一个重要风险群体。持续的哨点监测可以作为一种有用的工具，监测每个流感季节以及大流行期间流感病毒感染并发症的危险因素。
