Lim Cindy, Ang Li Wei, Ma Stefan, Lai Florence Yuk Lin, James Lyn, Cutter Jeffery
Epidemiology and Disease Control Division, Ministry of Health, Singapore.
Epidemiology and Disease Control Division, Ministry of Health, Singapore.
Vaccine. 2015 Jan 29;33(5):615-20. doi: 10.1016/j.vaccine.2014.12.029. Epub 2014 Dec 26.
BACKGROUND/OBJECTIVES: Singapore is a tropical country with influenza seasons occurring bi-annually. We compared the profile of severely ill patients with laboratory confirmed influenza A(H1N1)pdm09 infection in Singapore during the pandemic and post-pandemic periods, and studied their risk factors associated with mortality.
PATIENTS/METHODS: Three periods were defined for this study; pandemic period from 18 June to 29 August 2009, early post-pandemic period from 30 August 2009 to 12 February 2010, and late post-pandemic period from 13 February to 10 August 2010.
A total of 172 severely ill patients were admitted to hospitals from 18 June 2009 to 10 August 2010, of whom 23.8% died. The median age in the late post-pandemic period was significantly older than that in the early post-pandemic period (52 years versus 35 years, P=0.02). The median age of patients who died was significantly older than those who survived (52 years versus 44 years, P<0.01). The median length of stay under intensive care in the late post-pandemic period was twice that in the early post-pandemic (6 days versus 3 days, P=0.045). The proportion who died in the late post-pandemic period was more than 2.5 times that in the early post-pandemic period (29.8% versus 11.1%, P=0.043).
Severely ill patients were of older age in the late post-pandemic period. Older age was also significantly associated with mortality. It is important to maintain heightened vigilance and continue the surveillance of severely ill patients with influenza post-pandemic, so that patients with suspected infections could be promptly identified for early diagnosis and treatment.
背景/目的：新加坡是一个热带国家，每年有两个流感季节。我们比较了新加坡在大流行期间和大流行后时期实验室确诊的甲型H1N1流感pdm09感染重症患者的情况，并研究了与死亡率相关的危险因素。
患者/方法：本研究定义了三个时期；大流行期为2009年6月18日至8月29日，大流行后早期为2009年8月30日至2010年2月12日，大流行后晚期为2010年2月13日至8月10日。
2009年6月18日至2010年8月10日，共有172例重症患者入院，其中23.8%死亡。大流行后晚期患者的年龄中位数显著高于大流行后早期（52岁对35岁，P=0.02）。死亡患者的年龄中位数显著高于存活患者（52岁对44岁，P<0.01）。大流行后晚期重症监护病房的中位住院时间是大流行后早期的两倍（6天对3天，P=0.045）。大流行后晚期的死亡比例是大流行后早期的2.5倍多（29.8%对11.1%，P=0.043）。
大流行后晚期的重症患者年龄较大。年龄较大也与死亡率显著相关。大流行后保持高度警惕并继续对重症流感患者进行监测很重要，以便能及时识别疑似感染患者进行早期诊断和治疗。
