在重症监护室入院的严重形式的流感感染:对死亡率因素的分析
Victor Verdier1, François Lilienthal2, Arnaud Desvergez1
1Service de Réanimation CHU Réunion Saint-Denis France.
Influenza and other respiratory viruses
|July 24, 2023
概括
严重的流感需要进入重症监护室 (ICU),死亡率很高. 年龄和ARDS等因素增加了死亡风险,而oseltamivir治疗降低了死亡风险. H1N1菌株对结果没有影响.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 严重的流感感染带来了显著的死亡风险,特别是对于需要进入重症监护室 (ICU) 的患者.
- 以前的假设表明,新的H1N1菌株可能会增加流感相关的死亡率.
- 这项研究对十多年来接受ICU治疗的流感患者进行了检查,以确定死亡率预测因素.
研究的目的:
- 为了确定与因流感而入院ICU的成年患者的死亡率相关的因素.
- 分析患者人口统计,潜在疾病和治疗管理对ICU结果的影响.
- 评估特定流感菌株,如H1N1在患者死亡率中的作用.
主要方法:
- 对350名在2010年至2019年期间因流感而入院ICU的成年患者进行了回顾性分析.
- 数据收集包括人口统计信息,先前存在的疾病和接受的治疗.
- 使用单变量分析来确定与ICU死亡率相关的因素.
主要成果:
- 整体ICU死亡率为25.1%.
- 与死亡率增加显著相关的因素包括晚年 (>65岁),癌症史,输管 (尤其是早期),侵入性机械通风 (MV),急性呼吸困扰综合征 (ARDS),血管压缩剂使用,体外膜氧化 (ECMO),透析,细菌共感染,白血病,贫血和血栓症.
- 喘病史和奥塞塔米维尔治疗与死亡率降低有关;H1N1菌株没有影响结果.
结论:
- 虽然潜在的疾病影响住院,但只有年龄超过65岁,癌症史和细菌共感染影响了ICU死亡率.
- 肺部干扰,通常导致ARDS并需要MV,是一种常见的并发症,与ICU死亡率有很强的相关性.
- 建议包括对流感肺炎及时入院ICU,管理细菌 coinfections,和早期的oseltamivir管理.
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