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| Clinical characteristics of critical patients with pandemic influenza A (H1N1) virus infection in Chengdu, China |
| Li-hui Deng, Yi-lan Zeng, Ping Feng, Ya-ling Liu, Li-chun Wang, Yun Bai, Hong Tang |
| Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, China, Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University, Chengdu 610041, China, Chengdu Infectious Disease Hospital, Chengdu 610041, China |
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Abstract Objective: The critical illness of pandemic influenza A (H1N1) virus infection may be associated with relatively poor outcomes. The objective of this study is to describe clinical features and factors associated with the deaths of critical patients. Methods: Medical records of 26 critical patients with H1N1 infection admitted from Sept. 1 to Dec. 31, 2009, were retrospectively reviewed. Diagnosis was established by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay. Results: The mean age of the patients was (40.4±18.4) years and 73.1% of them were male. Clinical manifestations included fever, cough, and sputum production. The laboratory findings included leukocytosis, lymphopenia, C-reaction protein, and lactic dehydrogenase elevation. In this series, 17 subjects survived and 9 died. The parameters between the deaths and survivors were compared, which included acute physiology and chronic health evaluation II (APACHE II) scores (23.8±10.1 vs. 14.3±6.6, P<0.05), sequential organ failure assessment (SOFA) scores (13.3±3.0 vs. 6.6±3.3, P<0.05), and multiple organ dysfunction syndrome (MODS) scores (7.4±2.5 vs. 3.3±1.7, P<0.05). The cases of deaths had higher incidences of cardiovascular failure (100% vs. 41.2%, P<0.05), renal failure (55.6% vs. 11.7%, P<0.05), encephalopathy (44.4% vs. 5.9%, P<0.05), hepatic failure (33.3% vs. 5.9%, P<0.05), and septic shock (33.3% vs. 17.6%, P<0.05). Conclusions: The critical patients with H1N1 infection have high APACHE II, SOFA, and MODS scores, which may be associated with an increased risk of death and complex clinical courses.
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Received: 23 May 2011
Published: 30 December 2011
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