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Outcome of Critically Ill Patients With Influenza Infection: A Retrospective Study

BACKGROUND: Influenza causes significant morbidity and mortality in adults, and numerous patients require intensive care unit (ICU) admission. Acute respiratory distress syndrome (ARDS) is clearly described in this context, but other clinical presentations exist that need to be assessed for incidenc...

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Autores principales: Abaziou, Timothée, Delmas, Clément, Vardon Bounes, Fanny, Bignon, Fabien, Crognier, Laure, Seguin, Thierry, Riu-Poulenc, Béatrice, Ruiz, Stéphanie, Rouget, Antoine, Cougot, Pierre, Georges, Bernard, Conil, Jean-Marie, Minville, Vincent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7005979/
https://www.ncbi.nlm.nih.gov/pubmed/32082048
http://dx.doi.org/10.1177/1178633720904081
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author Abaziou, Timothée
Delmas, Clément
Vardon Bounes, Fanny
Bignon, Fabien
Crognier, Laure
Seguin, Thierry
Riu-Poulenc, Béatrice
Ruiz, Stéphanie
Rouget, Antoine
Cougot, Pierre
Georges, Bernard
Conil, Jean-Marie
Minville, Vincent
author_facet Abaziou, Timothée
Delmas, Clément
Vardon Bounes, Fanny
Bignon, Fabien
Crognier, Laure
Seguin, Thierry
Riu-Poulenc, Béatrice
Ruiz, Stéphanie
Rouget, Antoine
Cougot, Pierre
Georges, Bernard
Conil, Jean-Marie
Minville, Vincent
author_sort Abaziou, Timothée
collection PubMed
description BACKGROUND: Influenza causes significant morbidity and mortality in adults, and numerous patients require intensive care unit (ICU) admission. Acute respiratory distress syndrome (ARDS) is clearly described in this context, but other clinical presentations exist that need to be assessed for incidence and outcome. The primary goal of this study was to describe the characteristics of patients admitted in ICU for influenza, their clinical presentation, and the 3-month mortality rate. The second objective was to search for 3-month mortality risk factors. METHODS: This is a retrospective study including all patients admitted to 3 ICUs due to influenza-related disease between October 2013 and June 2016, which assesses the 3-month mortality rate. We compared clinical presentation, biological data, and outcome at 3 months between survivors and non-survivors. We created a predicting 3-month mortality model with Classification and Regression Tree analysis. RESULTS: Sixty-nine patients were included, 50 patients (72.5%) for ARDS, 5 (7.2%) for myocarditis, and 14 (20.3%) for acute respiratory failure without ARDS criteria. Non-typed influenza A was found in 30 cases (43.5%), influenza A H1N1 in 18 (26.1%), H3N2 in 3 (4.3%), and influenza B in 18 cases (27.5%). The 3-month mortality rate was 29% (n = 20). Extracorporeal membrane oxygenation (ECMO) was implanted in 23 patients, without any significant increase in mortality (39% vs 24% without ECMO, P = .19). A creatinine serum superior to 96 μmol/L, an aspartate aminotransferase level superior to 68 UI/L, and a Pao(2)/Fio(2) ration below 110 were associated with 3-month mortality in our predictive mortality model. CONCLUSION: Influenza in ICUs may have several clinical presentations. The mortality rate is high, but ECMO may be an effective rescue therapy.
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spelling pubmed-70059792020-02-20 Outcome of Critically Ill Patients With Influenza Infection: A Retrospective Study Abaziou, Timothée Delmas, Clément Vardon Bounes, Fanny Bignon, Fabien Crognier, Laure Seguin, Thierry Riu-Poulenc, Béatrice Ruiz, Stéphanie Rouget, Antoine Cougot, Pierre Georges, Bernard Conil, Jean-Marie Minville, Vincent Infect Dis (Auckl) Original Research BACKGROUND: Influenza causes significant morbidity and mortality in adults, and numerous patients require intensive care unit (ICU) admission. Acute respiratory distress syndrome (ARDS) is clearly described in this context, but other clinical presentations exist that need to be assessed for incidence and outcome. The primary goal of this study was to describe the characteristics of patients admitted in ICU for influenza, their clinical presentation, and the 3-month mortality rate. The second objective was to search for 3-month mortality risk factors. METHODS: This is a retrospective study including all patients admitted to 3 ICUs due to influenza-related disease between October 2013 and June 2016, which assesses the 3-month mortality rate. We compared clinical presentation, biological data, and outcome at 3 months between survivors and non-survivors. We created a predicting 3-month mortality model with Classification and Regression Tree analysis. RESULTS: Sixty-nine patients were included, 50 patients (72.5%) for ARDS, 5 (7.2%) for myocarditis, and 14 (20.3%) for acute respiratory failure without ARDS criteria. Non-typed influenza A was found in 30 cases (43.5%), influenza A H1N1 in 18 (26.1%), H3N2 in 3 (4.3%), and influenza B in 18 cases (27.5%). The 3-month mortality rate was 29% (n = 20). Extracorporeal membrane oxygenation (ECMO) was implanted in 23 patients, without any significant increase in mortality (39% vs 24% without ECMO, P = .19). A creatinine serum superior to 96 μmol/L, an aspartate aminotransferase level superior to 68 UI/L, and a Pao(2)/Fio(2) ration below 110 were associated with 3-month mortality in our predictive mortality model. CONCLUSION: Influenza in ICUs may have several clinical presentations. The mortality rate is high, but ECMO may be an effective rescue therapy. SAGE Publications 2020-02-06 /pmc/articles/PMC7005979/ /pubmed/32082048 http://dx.doi.org/10.1177/1178633720904081 Text en © The Author(s) 2020 https://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Abaziou, Timothée
Delmas, Clément
Vardon Bounes, Fanny
Bignon, Fabien
Crognier, Laure
Seguin, Thierry
Riu-Poulenc, Béatrice
Ruiz, Stéphanie
Rouget, Antoine
Cougot, Pierre
Georges, Bernard
Conil, Jean-Marie
Minville, Vincent
Outcome of Critically Ill Patients With Influenza Infection: A Retrospective Study
title Outcome of Critically Ill Patients With Influenza Infection: A Retrospective Study
title_full Outcome of Critically Ill Patients With Influenza Infection: A Retrospective Study
title_fullStr Outcome of Critically Ill Patients With Influenza Infection: A Retrospective Study
title_full_unstemmed Outcome of Critically Ill Patients With Influenza Infection: A Retrospective Study
title_short Outcome of Critically Ill Patients With Influenza Infection: A Retrospective Study
title_sort outcome of critically ill patients with influenza infection: a retrospective study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7005979/
https://www.ncbi.nlm.nih.gov/pubmed/32082048
http://dx.doi.org/10.1177/1178633720904081
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