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墨西哥城一家转诊医院中流感对儿童的影响:临床负担及机械通气的预测因素

Impact of Influenza on Children in a Referral Hospital in Mexico City: Clinical Burden and Predictors of Mechanical Ventilation.

作者信息

Jiménez-Juárez Rodolfo Norberto, Moreno-Espinosa Sarbelio, Reyes-Lopez Alfonso, Parra-Ortega Israel, Laris-Gonzalez Almudena, De la Rosa-Zamboni Daniela, Guerra-de-Blas Paola, Gamiño-Arroyo Ana Estela

机构信息

Department of Infectious Diseases, Federico Gómez Children's Hospital of Mexico, Mexico City 06720, Mexico.

Medica Sur Hospital, Mexico City 14059, Mexico.

出版信息

Viruses. 2025 May 28;17(6):771. doi: 10.3390/v17060771.

Abstract

Influenza is a highly transmissible seasonal disease that significantly impacts public health worldwide, causing lower respiratory tract infections, numerous hospitalizations, and prolonged stays. However, data on its clinical burden in children in Latin America remain limited. This retrospective cohort study analyzed the demographic and clinical characteristics of children hospitalized with influenza in Latin America, stratified by age, and identified factors associated with mechanical ventilation. Medical records of children with severe acute respiratory infection associated with influenza were reviewed. Statistical analyses included chi square and Wilcoxon tests to compare groups, and Cox regression to identify predictors of mechanical ventilation. Among 212 cases, 46% of admissions were in school-age children; 93.4% had comorbidities. Influenza AH1N1 was more frequent in children <5 years and influenza H3N2 in children >5 years of age. The mechanical ventilation rate per age group was 24.1% among those <1 year, 29.8% in 1-4 years of age, 4.9% in 5-9 years of age, and 26.3% in children 10-18 years of age. Hypotension, paradoxical breathing, and nosocomial infection were identified as predictors for mechanical ventilation. These findings enhance the understanding of influenza's clinical impact on pediatric populations, particularly in predicting severe outcomes requiring intensive care, and aid in developing strategies to mitigate its effects.

摘要

流感是一种极易传播的季节性疾病,对全球公共卫生有重大影响,可导致下呼吸道感染、大量住院以及住院时间延长。然而,拉丁美洲儿童流感临床负担的数据仍然有限。这项回顾性队列研究分析了拉丁美洲因流感住院儿童的人口统计学和临床特征,并按年龄分层,确定了与机械通气相关的因素。对与流感相关的严重急性呼吸道感染儿童的病历进行了审查。统计分析包括卡方检验和Wilcoxon检验以比较各组,并采用Cox回归分析来确定机械通气的预测因素。在212例病例中,46%的入院儿童为学龄儿童;93.4%的儿童患有合并症。甲型H1N1流感在5岁以下儿童中更为常见,而H3N2流感在5岁以上儿童中更为常见。各年龄组的机械通气率分别为:1岁以下儿童为24.1%,1-4岁儿童为29.8%,5-9岁儿童为4.9%,10-18岁儿童为26.3%。低血压、反常呼吸和医院感染被确定为机械通气的预测因素。这些发现增进了对流感对儿童人群临床影响的理解,特别是在预测需要重症监护的严重后果方面,并有助于制定减轻其影响的策略。

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