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Rev Bras Ter Intensiva. 2009 Aug;21(3):231-6.

Outcome of influenza A (H1N1) patients admitted to intensive care units in the Paraná state, Brazil.

[Article in English, Portuguese]

Author information

1
Universidade Estadual do Oeste do Paraná, Cascavel, PR, Brasil.
2
Hospital das Nações, Curitiba, PR, Brasil.
3
Hospital do Trabalhador, Curitiba, PR, Brasil.
4
Hospital Cajuru, Curitiba, PR, Brasil.
5
Hospital São Lucas, Curitiba, PR, Brasil.
6
Hospital Universitário Regional.
7
Hospital Universitário, Maringá, PR, Brasil.
8
Santa Casa, Campo Mourão, PR, Brasil.
9
Hospital Policlínica.
10
Hospital Universitário do Oeste do Paraná, Cascavel, PR, Brasil.
11
Hospital Costa Cavalcanti, Foz do Iguaçu, PR, Brasil.
12
Faculdade Assis Gurgacz, Hospital São Lucas, Cascavel, PR, Brasil.
13
Universidade Federal do Paraná, Curitiba, PR, Brasil.

Abstract

OBJECTIVE:

This study aimed to analyze outcome, clinical and epidemiological characteristics and severity factors in adult patients admitted with a diagnosis of infection by virus A (H1N1) to public and private intensive care units, in Paraná, Brazil.

METHODS:

Cohort study of medical charts of patients older than 12 years admitted to 11 intensive care units in 6 cities in the state of Parana, Brazil, during a period of 45 days, with diagnosis of swine influenza. The diagnosis of infection with A (H1N1) was made by real time polymerase chain reaction (RT-PCR) of nasopharyngeal secretion, or strong clinical suspicion when other causes had been ruled out (even with negative RT-PCR). Descriptive statistics were performed, analysis by the Chi square test was used to compare percentages and the Student's t test for continuous variables with univariate analysis, assuming a significance level of p <0.05.

RESULTS:

There were 63 adult patients admitted with a diagnosis of H1N1, 37 (58.7%) being RT-PCR positive. Most patients were young adults (65% under 40 years of age) with no gender predominance and high incidence of obesity (27.0% with Body Mass Index > 30). Mean of the Acute Physiologic Chronic Health Evaluation II (APACHE II) score was 15.0 + 8.1. Mortality in the intensive care unit was 39.7%. The main factors associated with mortality were: positive RT-PCR, low levels of initial PaO2/FiO2, high initial levels of urea and lactate dehydrogenase, required level of positive end expiratory pressure, need for the prone position and vasopressors.

CONCLUSIONS:

Adult patients with A (H1N1) virus infection admitted to intensive care units had a high risk of death, particularly due to respiratory impairment. Positive RT-PCR, urea and lactic dehydrogenase, low initial PaO2/FiO2 and high levels of PEEP were correlated with higher mortality.

PMID:
25303543

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