Journal of Global Infectious DiseasesOfficial Publishing of INDUSEM and OPUS 12 Foundation, Inc. Users online:1362  
Print this pageEmail this pageSmall font sizeDefault font sizeIncrease font size     
Home About us Editors Ahead of Print Current Issue Archives Search Instructions Subscribe Advertise Login 
 
ORIGINAL ARTICLE
Year : 2012  |  Volume : 4  |  Issue : 3  |  Page : 145-152

Clinical profile and predictors of mortality of severe pandemic (H1N1) 2009 virus infection needing intensive care: A multi-centre prospective study from South India


1 Medical Intensive Care Unit, Christian Medical College Hospital, Vellore, India
2 Medical Intensive Care Unit, St. John's Medical College Hospital, Bangalore, India
3 Medical Intensive Care Unit, Manipal Hospital, Bangalore, India
4 Department of Virology, Christian Medical College Hospital, Vellore, India
5 Department of Biostatistics, Christian Medical College Hospital, Vellore, India
6 Department of Medicine, Christian Medical College Hospital, Vellore, India

Correspondence Address:
Kartik Ramakrishna
Medical Intensive Care Unit, Christian Medical College Hospital, Vellore
India
Login to access the Email id

Source of Support: Financial support for testing of samples was from an ongoing influenza surveillance project funded by the Department of Health and Human Services, USA and Indian council of Medical Research (ICMR) (Co-operative Agreement No. 5U50/C1024407-05). Reagents for testing were supplied by the National Institute of Virology, Pune, India., Conflict of Interest: None


DOI: 10.4103/0974-777X.100569

Rights and Permissions

Background: This multi-center study from India details the profile and outcomes of patients admitted to the intensive care unit (ICU) with pandemic Influenza A (H1N1) 2009 virus [P(H1N1)2009v] infection. Materials and Methods: Over 4 months, adult patients diagnosed to have P(H1N1)2009v infection by real-time RT-PCR of respiratory specimens and requiring ICU admission were followed up until death or hospital discharge. Sequential organ failure assessment (SOFA) scores were calculated daily. Results: Of the 1902 patients screened, 464 (24.4%) tested positive for P(H1N1)2009v; 106 (22.8%) patients aged 35±11.9 (mean±SD) years required ICU admission 5.8±2.7 days after onset of illness. Common symptoms were fever (96.2%), cough (88.7%), and breathlessness (85.9%). The admission APACHE-II and SOFA scores were 14.4±6.5 and 5.5±3.1, respectively. Ninety-six (90.6%) patients required ventilation for 10.1±7.5 days. Of these, 34/96 (35.4%) were non-invasively ventilated; 16/34 were weaned successfully whilst 18/34 required intubation. Sixteen patients (15.1%) needed dialysis. The duration of hospitalization was 14.0±8.0 days. Hospital mortality was 49%. Mortality in pregnant/puerperal women was 52.6% (10/19). Patients requiring invasive ventilation at admission had a higher mortality than those managed with non-invasive ventilation and those not requiring ventilation (44/62 vs. 8/44, P<0.001). Need for dialysis was independently associated with mortality (P=0.019). Although admission APACHE-II and SOFA scores were significantly (P<0.02) higher in non-survivors compared with survivors on univariate analysis, individually, neither were predictive on multivariate analysis. Conclusions: In our setting, a high mortality was observed in patients admitted to ICU with severe P(H1N1)2009v infection. The need for invasive ventilation and dialysis were associated with a poor outcome.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed3158    
    Printed155    
    Emailed2    
    PDF Downloaded17    
    Comments [Add]    
    Cited by others 3    

Recommend this journal

 

Sitemap | What's New | Feedback | Copyright and Disclaimer | Contact Us
2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008