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2016-2018 年季节严重流感患者的临床表现和死亡风险因素。

Clinical manifestations and risk factors for mortality of patients with severe influenza during the 2016-2018 season.

机构信息

Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan.

Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

Int J Infect Dis. 2020 Jun;95:347-351. doi: 10.1016/j.ijid.2020.04.013. Epub 2020 Apr 11.

Abstract

OBJECTIVES

Influenza remains a crucial transmissible disease from community. We aim to identify risk factors associated with mortality among hospitalized patients with severe influenza.

METHODS

We retrospectively reviewed medical records of adult patients with laboratory-confirmed severe influenza at a medical center between January 2016 and December 2018. The primary outcome was 30-day all-cause mortality.

RESULTS

Totally 96 patients were enrolled, with 73 patients in the influenza A group and 23 in the influenza B group. Eighteen (18.8%) deaths occurred within 30 days of hospitalization, including 8 (11%) and 10 (43.5%) of each group. In multivariable Cox regression analysis, factors associated with mortality were underlying diseases of liver cirrhosis (adjusted hazard ratio [AHR], 3.94; 95% CI, 1.07-14.45) and rheumatologic diseases (AHR, 7.45; 95% CI, 2.34-23.69) and the diagnosis of influenza B (AHR, 4.33; 95% CI, 1.68-11.13).

CONCLUSIONS

Clinician should early identify high-risk population and warning signs of severe influenza. Our results support the policy of quadrivalent influenza vaccination because influenza B could be associated with high mortality.

摘要

目的

流感仍然是一种严重的社区传播疾病。本研究旨在确定与住院重症流感患者死亡相关的危险因素。

方法

我们回顾性分析了 2016 年 1 月至 2018 年 12 月期间某医疗中心确诊为严重流感的成年患者的病历。主要结局为 30 天全因死亡率。

结果

共纳入 96 例患者,甲型流感组 73 例,乙型流感组 23 例。18 例(18.8%)患者在住院后 30 天内死亡,其中甲型流感组 8 例(11%),乙型流感组 10 例(43.5%)。多变量 Cox 回归分析显示,与死亡相关的因素包括肝硬化(调整后的危险比 [AHR],3.94;95%置信区间 [CI],1.07-14.45)和风湿性疾病(AHR,7.45;95% CI,2.34-23.69)等基础疾病以及乙型流感的诊断(AHR,4.33;95% CI,1.68-11.13)。

结论

临床医生应早期识别重症流感的高危人群和预警信号。我们的研究结果支持四价流感疫苗接种政策,因为乙型流感可能与高死亡率相关。

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