신종 플루 폐렴으로 입원한 환자들에서 주요 합병증 발생과 관련된 인자

Background: To date, there are few data on the risk factors for severe cases and deaths associated with the 2009 pandemic H1N1 influenza A. Here, we describe the clinical and epidemiologic characteristics of patients hospitalized for pneumonia and identify those factors associated with the developme...

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Veröffentlicht in:Tuberculosis and respiratory diseases 2010, 68(3), 302, pp.162-167
Hauptverfasser: 최상식, Sang Sik Choi, 김원영, Won Young Kim, 김성한, Sung Han Kim, 홍상범, Sang Bum Hong, 임채만, Chae Man Lim, 고윤석, Youn Suck Koh, 김원, Won Kim, 임경수, Kyung Su Lim
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Zusammenfassung:Background: To date, there are few data on the risk factors for severe cases and deaths associated with the 2009 pandemic H1N1 influenza A. Here, we describe the clinical and epidemiologic characteristics of patients hospitalized for pneumonia and identify those factors associated with the development of major complications (MC). Methods: We reviewed the medical records of 41 cases of pneumonia admitted to a university-affiliated tertiary hospital between Aug 26 and Dec 10, 2009, and who had confirmed H1N1 influenza A based on real-time reverse transcriptase-polymerase-chain-reaction assay. There were 7,962 patients that fit these criteria. We compared the clinical features and demographic characteristics of patients who developed MC to with those who did not develop MC. Results: During the study period, 10 patients developed MC (required admission to the intensive care unit, n=10; required ventilator therapy, n=6; death, n=4). Patients with MC were significantly older than those without MC and more frequently had underlying medical conditions (90.0% vs 41.9%, p-value <0.01). In the patients with developed MC, the median PaO2/FiO2 ratio of 230.0 (145.0∼347.3) at admission and pneumonia severity index (PSI) score of 141.5 (88.3∼158.5) were higher than patients without MC. However, no differences were observed in laboratory findings or in viral shedding between the 2 groups. Conclusion: In hospitalized pneumonia patients of 2009 H1N1 influenza, old age, a history of malignancy, initial hypoxemia, PaO2/FiO2 ratio, and PSI score appear to be risk factor significantly related to developing MC. These findings might be the basis to influence strategies for admitting patients to an intensive or intermediate care unit and for pre-emptive antiviral therapy.
ISSN:1738-3536
2005-6184