A Prediction Rule to Identify Severe Cases among Adult Patients Hospitalized with Pandemic Influenza A (H1N1) 2009.
10.3346/jkms.2011.26.4.499
- Author:
Won Sup OH
1
;
Seung Joon LEE
;
Chang Seop LEE
;
Ji An HUR
;
Ae Chung HUR
;
Yoon Seon PARK
;
Sang Taek HEO
;
In Gyu BAE
;
Sang Won PARK
;
Eu Suk KIM
;
Hong Bin KIM
;
Kyoung Ho SONG
;
Kkot Sil LEE
;
Sang Rok LEE
;
Joon Sup YEOM
;
Su Jin LEE
;
Baek Nam KIM
;
Yee Gyung KWAK
;
Jae Hoon LEE
;
Yong Keun KIM
;
Hyo Youl KIM
;
Nam Joong KIM
;
Myoung Don OH
Author Information
1. Department of Internal Medicine, Kangwon National University School of Medicine, Chucheon, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
pandemic influenza A (H1N1) 2009;
Severity;
Risk Factors;
Prediction Rule
- MeSH:
APACHE;
Adult;
Aged;
Antiviral Agents/therapeutic use;
Female;
Hospitalization;
Humans;
Influenza A Virus, H1N1 Subtype/*isolation & purification;
Influenza, Human/drug therapy/*epidemiology/mortality;
Intensive Care Units;
Male;
Middle Aged;
Pandemics;
Predictive Value of Tests;
ROC Curve;
Respiration, Artificial;
Risk Factors;
Severity of Illness Index
- From:Journal of Korean Medical Science
2011;26(4):499-506
- CountryRepublic of Korea
- Language:English
-
Abstract:
The purpose of this study was to establish a prediction rule for severe illness in adult patients hospitalized with pandemic influenza A (H1N1) 2009. At the time of initial presentation, the baseline characteristics of those with severe illness (i.e., admission to intensive care unit, mechanical ventilation, or death) were compared to those of patients with non-severe illnesses. A total of 709 adults hospitalized with pandemic influenza A (H1N1) 2009 were included: 75 severe and 634 non-severe cases. The multivariate analysis demonstrated that altered mental status, hypoxia (PaO2/FiO2 < or = 250), bilateral lung infiltration, and old age (> or = 65 yr) were independent risk factors for severe cases (all P < 0.001). The area under the ROC curve (0.834 [95% CI, 0.778-0.890]) of the number of risk factors were not significantly different with that of APACHE II score (0.840 [95% CI, 0.790-0.891]) (P = 0.496). The presence of > or = 2 risk factors had a higher sensitivity, specificity, positive predictive value and negative predictive value than an APACHE II score of > or = 13. As a prediction rule, the presence of > or = 2 these risk factors is a powerful and easy-to-use predictor of the severity in adult patients hospitalized with pandemic influenza A (H1N1) 2009.
