Format

Send to

Choose Destination
J Am Geriatr Soc. 2013 Mar;61(3):350-6.

Epidemiology, clinical features, and prognosis of elderly adults with severe forms of influenza A (H1N1.

Collaborators (267)

Cobo P, Martins J, Carbayo C, Robles-Musso E, Cárdenas A, Fierro J, Fernández DO, Sierra R, Huertos MJ, Pozo JC, Guerrero R, Márquez E, Rodríguez - Carvajal M, Jiménez JR, Estella Á, Pomares J, Ballesteros JL, Fernández Y, Lobato F, Prieto JF, Albofedo - Sánchez J, Martínez P, de la Torre MV, Nieto M, Castellanos MA, Sevilla G, Garnacho - Montero J, Hinojosa R, Fernández E, Loza A, León C, Arenzana A, Ocaña D, Navarrete I, Beryanaki MZ, Sánchez I, Serón C, Avellanas ML, Lacueva MI, Luque P, Serrano EP, Lázaro JF, González I, Montón JM, Regil PD, Iglesias L, González CP, García - Rodríguez Á, Socias L, Ibánez P, Borges-Sa M, Socias A, Del Castillo A, Marcos RJ, Bonell JM, Amestarán I, Ruiz-Santana S, Molina J, Hernández D, Trujillo A, Regalado L, Lorente L, Martín M, Martínez S, Cáceres JJ, Suberviola B, Ugarte P, García-López F, Alonso AÁ, Pasilla A, Grande ML, Albaya A, Canabal A, Marina L, Simón A, Añón JM, Messa JB, Pueyo MJ, María del valle O, Ferreras Z, Macias S, Berezo JÁ, Varela JB, Terrero AÁ, Ezpeleta FT, Paez Z, García Á, Catalán RM, Ferrer M, Torres A, Cilloniz C, Barbadillo S, Cabré L, Baeza I, Rovira A, Álvarez-Lerma F, Vázquez A, Nolla J, Fernández F, Cervelló JR, Iglesia R, Mañéz R, Ballús J, Granada RM, Vallés J, Ortíz M, Guía C, Páez J, Almirall J, Balanzo X, Rello J, Arnau E, Pérez M, Laborda C, Souto J, Catalán I, Sirvent JM, Ferri C, de Arbina NL, Badía M, Baseda - Garrido B, Magret M, Esteban MF, Luna J, Josic Z, Gurri F, Rodríguez P, Rodríguez A, Lisboa T, Pobo Á, Trefler S, Díaz RM, Mesalles E, Arméstar F, de Mendoza D, José JN, Fernández - Zapata A, Recio T, Arrascaeta A, García-Ramos MJ, Gallego E, Bueno F, Díaz M, Cordero ML, Pastor JA, Álvarez - Rocha L, Coruña A, Vila D, González CF, Merayo E, López-Ciudad VJ, Cañones JC, Vilaboy E, Chao JV, Saborido EM, González RJ, Domínguez H, Alemparte E, Ortega A, López AM, Canabal J, Ferres E, Monzón JL, Goñi F, Navalpotro MB, Ochoa S, García - Torrejón MC, Pérez - Calvo C, Arnaiz L, Sánchez - Alonso S, del Río F, González MÁ, Martín MC, Molina JM, Montejo JC, Albert P, de Pablo A, Guerrero JE, Zurita M, Peyrat JB, Cerdá E, Alvarez M, Pey C, Rodríguez M, Palencia E, Caballero R, Vaquero C, Mariscal F, García S, Carrasco N, Ramos R, Galván B, Figueira JC, Soriano M, Galdós P, Moreno BB, Hermosa C, Gordo F, Algora A, Paredes A, Cambronero JA, Gómez-Rosado S, López LM, JA L, Martínez S, Abad F, Martínez M, Butí SM, Rueda BG, García F, Macaya L, Redin LM, Tellería A, Insansti J, González N, Marco P, Santamaría B, Rodríguez T, Vergara JC, Amiano JR, Manzano A, Arenal CC, Olaechea PM, Martín H, Blanquer J, Valero RR, Belenger A, Altaba S, Álvarez B, Picos A, Sánchez-Miralles Á, Cebrian J, Cuñat J, Romero B, Zaragoza R, Tormo C, Paricio V, Marques A, Sánchez-Morcillo S, Tormo S, García MÁ, Ribas A, Lander A, Ramírez de Arellano SG, Díaz JJ, Sisón, Palomar M, Ma Nava J, de Molina JG, Pérez JB, Piquer MO, Freita S, Del Nogal Sáez F, López D, Velayos C, Catalán M, Prieto I, Liétor A, del Cabo F, Esteban A, Nin N, Maraví-Poma E, Urra IJ, Vidaur L, Bonastre J, Palamo M, Latour J.

Author information

1
Critical Care and Emergency Department, Hospital Virgen del Rocío, Seville, Spain. jgarnachom@gmail.com

Abstract

OBJECTIVES:

To examine epidemiological and clinical data of individuals aged 65 and older with influenza virus A (H1N1) admitted to the intensive care unit (ICU) and to identify independent predictors of ICU mortality.

DESIGN:

Prospective, observational, multicenter study to determine prognostic factors in individuals infected with influenza A (H1N1) admitted to the ICU.

SETTING:

One hundred forty-eight Spanish ICUs.

PARTICIPANTS:

Individuals with influenza A (H1N1) confirmed using real-time polymerase chain reaction from April 2009 to July 2011.

MEASUREMENTS:

Individuals aged 65 and older were compared with younger individuals. A multivariate analysis was conducted to determine independent predictors of mortality in this population.

RESULTS:

One thousand one hundred twenty individuals (129 (11.5%) aged 65) were included. Prevalence of chronic diseases was more common in older individuals. Viral pneumonitis was more frequent in individuals younger than 65 (70.5% vs 54.3%, P < .001). In older individuals, Acute Physiology and Chronic Health Evaluation II score (odds ratio (OR) = 1.11, 95% confidence interval (CI) = 1.11–1.20, P = .002), immunosuppression (OR = 3.66, 95% CI, 1.33–10.03, P = .01) and oseltamivir therapy initiated after 48 hours (OR = 3.32, 95% CI = 1.02–10.8, P = .04) were identified as independent variables associated with mortality. Corticosteroid use was associated with a trend toward greater mortality (OR = 2.39, 95% CI = 0.98–5.91, P = .06).

CONCLUSION:

Individuals aged 65 and older with influenza A (H1N1) admitted to the ICU have a higher incidence of underlying diseases than younger individuals and differences in clinical presentation. Early oseltamivir therapy is associated with better outcomes in elderly adults.

PMID:
23496351
DOI:
10.1111/jgs.12152
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center