Clinical Characteristics and Predictors of Mortality in Critically Ill Adult Patients with Influenza Infection

Wei-Cheng Hong, Shu-Fen Sun, Chien-Wei Hsu, David-Lin Lee and Chao-Hsien Lee
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Wei-Cheng Hong: Division of Pulmonary Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813779, Taiwan
Shu-Fen Sun: School of Medicine, National Yang-Ming University, Taipei 112304, Taiwan
Chien-Wei Hsu: Division of Pulmonary Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813779, Taiwan
David-Lin Lee: Division of Pulmonary Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813779, Taiwan
Chao-Hsien Lee: Department of Health Business Administration, Meiho University, Pingtung 912009, Taiwan

IJERPH, 2021, vol. 18, issue 7, 1-8

Abstract: Patients with influenza infection may develop acute respiratory distress syndrome (ARDS), which is associated with high mortality. Some patients with ARDS receiving extracorporeal membrane oxygenation (ECMO) support die of infectious complications. We aimed to investigate the risk factors affecting the clinical outcomes in critically ill patients with influenza. We retrospectively reviewed the medical records of influenza patients between January 2006 and May 2016 at the Kaohsiung Veterans General Hospital in Taiwan. Patients aged below 20 years or without laboratory-confirmed influenza were excluded. Critically ill patients who presented with ARDS ( P = 0.004, odds ratio (OR): 8.054, 95% confidence interval (CI): 1.975–32.855), a higher Acute Physiology and Chronic Health Evaluation (APACHE) II score ( P = 0.008, OR: 1.102, 95% CI: 1.025–1.184), or higher positive end-expiratory pressure ( P = 0.008, OR: 1.259, 95% CI: 1.061–1.493) may have a higher risk of receiving ECMO. Influenza A ( P = 0.037, OR: 0.105, 95% CI: 0.013–0.876) and multiple organ failure ( P = 0.007, OR: 0.056, 95% CI: 0.007–0.457) were significantly associated with higher mortality rates. In conclusion, our study showed critically ill influenza patients with ARDS, higher APACHE II scores, and higher positive end-expiratory pressure have a higher risk of receiving ECMO support. Influenza A and multiple organ failure are predictors of mortality.

Keywords: acute respiratory distress syndrome; extracorporeal membrane oxygenation; multiple organ failure; outcome; severe influenza (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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