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.
Int J Infect Dis. 2020 Jun;95:347-351. doi: 10.1016/j.ijid.2020.04.013. Epub 2020 Apr 11.
Influenza remains a crucial transmissible disease from community. We aim to identify risk factors associated with mortality among hospitalized patients with severe influenza.
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.
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).
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.
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。
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。
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)。
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。