Journal of Global Infectious Diseases

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


Kartik Ramakrishna1, Sriram Sampath2, Jose Chacko3, Binila Chacko1, Deshikar L Narahari2, Hemanth H Veerendra3, Mahesh Moorthy4, Bhuvana Krishna2, VS Chekuri1, Rama Krishna Raju2, Devika Shanmugasundaram5, Kishore Pichamuthu1, Asha M Abraham4, OC Abraham6, Kurien Thomas6, Prasad Mathews6, George M Varghese6, Priscilla Rupali6, John V Peter1 
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

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.


How to cite this article:
Ramakrishna K, Sampath S, Chacko J, Chacko B, Narahari DL, Veerendra HH, Moorthy M, Krishna B, Chekuri V S, Raju RK, Shanmugasundaram D, Pichamuthu K, Abraham AM, Abraham O C, Thomas K, Mathews P, Varghese GM, Rupali P, Peter JV. Clinical profile and predictors of mortality of severe pandemic (H1N1) 2009 virus infection needing intensive care: A multi-centre prospective study from South India.J Global Infect Dis 2012;4:145-152


How to cite this URL:
Ramakrishna K, Sampath S, Chacko J, Chacko B, Narahari DL, Veerendra HH, Moorthy M, Krishna B, Chekuri V S, Raju RK, Shanmugasundaram D, Pichamuthu K, Abraham AM, Abraham O C, Thomas K, Mathews P, Varghese GM, Rupali P, Peter JV. Clinical profile and predictors of mortality of severe pandemic (H1N1) 2009 virus infection needing intensive care: A multi-centre prospective study from South India. J Global Infect Dis [serial online] 2012 [cited 2021 Jan 22 ];4:145-152
Available from: https://www.jgid.org/article.asp?issn=0974-777X;year=2012;volume=4;issue=3;spage=145;epage=152;aulast=Ramakrishna;type=0