Mortality and severity evaluation by routine pneumonia prediction models among Japanese patients with 2009 pandemic influenza A (H1N1) pneumonia

Fujikura, Yuji; Kawano, Shuichi; Kouzaki, Yuji; Shinoda, Masahiro; Hara, Yu; Shinkai, Masaharu; Kanoh, Soichiro; Kawana, Akihiko

doi:10.1016/j.resinv.2014.04.003

Cited by 14 publications

(15 citation statements)

References 29 publications

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“…The mortality associated with severe H1N1 infections was reported as high as 20%‐40% . In a study of 320 pandemic influenza pneumonia in Japan, 43 (13.4%) had received invasive mechanical ventilation and 7.8% died of severe pneumonia …”

Section: Introductionmentioning

confidence: 99%

Recovery of pulmonary functions, exercise capacity, and quality of life after pulmonary rehabilitation in survivors of ARDS due to severe influenza A (H1N1) pneumonitis

Hsieh

Lee

Cho

et al. 2018

Influenza Resp Viruses

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BackgroundAcute respiratory distress syndrome (ARDS) due to severe influenza A H1N1 pneumonitis would result in impaired pulmonary functions and health‐related quality of life (HRQoL) after hospital discharge.ObjectivesThe recovery of pulmonary functions, exercise capacity, and HRQoL in the survivors of ARDS due to 2009 pandemic influenza A H1N1 pneumonitis (H1N1‐ARDS) was evaluated in a tertiary teaching hospital in northern Taiwan between May 2010 and June 2011.Patients and MethodsData of spirometry, total lung capacity (TLC), diffusing capacity of carbon monoxide (DLCO), and 6‐minute walk distance (6MWD) in the patients survived from H1N1‐ARDS were collected 1, 3, and 6 months post‐hospital discharge. HRQoL was evaluated with St. George respiratory questionnaire (SGRQ).ResultsNine survivors of H1N1‐ARDS in the study period were included. All these patients received 2 months’ pulmonary rehabilitation program. Pulmonary functions and exercise capacity included TLC, forced vital capacity (FVC), forced expiratory volume in the first second (FEV 1), DLCO, and 6MWD improved from 1 to 3 months post‐hospital discharge. Only TLC had further significant improvement from 3 to 6 months. HRQoL represented as the total score of SGRQ had no significant improvement in the first 3 months but improved significantly from 3 to 6 months post‐discharge.ConclusionThe impaired pulmonary functions and exercise capacity in the survivors of H1N1‐ARDS improved soon at 3 months after hospital discharge. Their quality of life had keeping improved at 6 months even though there was no further improvement of their pulmonary functions and exercise capacity.

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Section: Introductionmentioning

confidence: 99%

Recovery of pulmonary functions, exercise capacity, and quality of life after pulmonary rehabilitation in survivors of ARDS due to severe influenza A (H1N1) pneumonitis

Hsieh

Lee

Cho

et al. 2018

Influenza Resp Viruses

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“…But current CAP severity scores (PSI, CURB‐65 and CRB‐65) in predicting mortality in patients with influenza pneumonia is unpersuasive. Several studies indicated that current CAP severity scores failed to predict mortality in patients due to influenza pneumonia. Only one research pointed out that SMART‐COP presented the best performance to indicate intensive care unit (ICU) admission in patients with H1N1 pneumonia .…”

Section: Introductionmentioning

confidence: 99%

Mortality prediction to hospitalized patients with influenza pneumonia: PO₂/FiO₂ combined lymphocyte count is the answer

Shi

et al. 2015

Clinical Respiratory J

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Introduction Community‐acquired pneumonia (CAP) severity scores perform well in predicting mortality of CAP patients, but their applicability in influenza pneumonia is powerless. Objectives The aim of our research was to test the efficiency of PO2/FiO2 and CAP severity scores in predicting mortality and intensive care unit (ICU) admission with influenza pneumonia patients. Methods We reviewed all patients with positive influenza virus RNA detection in Beijing Chao‐Yang Hospital during the 2009–2014 influenza seasons. Outpatients, inpatients with no pneumonia and incomplete data were excluded. We used receiver operating characteristic curves (ROCs) to verify the accuracy of severity scores or indices as mortality predictors in the study patients. Results Among 170 hospitalized patients with influenza pneumonia, 30 (17.6%) died. Among those who were classified as low‐risk (predicted mortality 0.1%–2.1%) by pneumonia severity index (PSI) or confusion, urea, respiratory rate, blood pressure, age ≥65 year (CURB‐65), the actual mortality ranged from 5.9 to 22.1%. Multivariate logistic regression indicated that hypoxia (PO2/FiO2 ≤ 250) and lymphopenia (peripheral blood lymphocyte count <0.8 × 109/L) were independent risk factors for mortality, with OR value of 22.483 (95% confidence interval 4.927–102.598) and 5.853 (95% confidence interval 1.887–18.152), respectively. PO2/FiO2 combined lymphocyte count performed well for mortality prediction with area under the curve (AUC) of 0.945, which was significantly better than current CAP severity scores of PSI, CURB‐65 and confusion, respiratory rate, blood pressure, age ≥65 years for mortality prediction (P < 0.001). The scores or indices for ICU admission prediction to hospitalized patients with influenza pneumonia confirmed a similar pattern and PO2/FiO2 combined lymphocyte count was also the best predictor for predicting ICU admission. Conclusion In conclusion, we found that PO2/FiO2 combined lymphocyte count is simple and reliable predictor of hospitalized patients with influenza pneumonia in predicting mortality and ICU admission. When PO2/FiO2 ≤ 250 or peripheral blood lymphocyte count <0.8 × 109/L, the clinician should pay great attention to the possibility of severe influenza pneumonia.

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“…Several previous studies have reported the use of different prognostic scales of pneumonia to evaluate influenza [39][40][41][42][43][44]. Myles et al [39] compared the performance of Community Assessment Tools (CATs), CURB-65 score, and the Pandemic Medical Early Warning Score in influenza.…”

Section: Discussionmentioning

confidence: 99%

Prognostic accuracy of SIRS criteria and qSOFA score for in-hospital mortality among influenza patients in the emergency department

Chu

Seak

et al. 2020

BMC Infect Dis

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Background: The seasonal influenza epidemic is an important public health issue worldwide. Early predictive identification of patients with potentially worse outcome is important in the emergency department (ED). Similarly as with bacterial infection, influenza can cause sepsis. This study was conducted to investigate the effectiveness of the Systemic Inflammatory Response Syndrome (SIRS) criteria and the quick Sequential Organ Failure Assessment (qSOFA) score as prognostic predictors for ED patients with influenza. Methods: This single-center, retrospective cohort study investigated data that was retrieved from a hospital-based research database. Adult ED patients (age ≥ 18 at admission) with laboratory-proven influenza from 2010 to 2016 were included for data analysis. The initial SIRS and qSOFA scores were both collected. The primary outcome was the utility of each score in the prediction of in-hospital mortality. Results: For the study period, 3561 patients met the study inclusion criteria. The overall in-hospital mortality was 2.7% (95 patients). When the qSOFA scores were 0, 1, 2, and 3, the percentages of in-hospital mortality were 0.6, 7.2, 15.9, and 25%, respectively. Accordingly, the odds ratios (ORs) were 7.72, 11.92, and 22.46, respectively. The sensitivity and specificity was 24 and 96.2%, respectively, when the qSOFA score was ≥2. However, the SIRS criteria showed no significant associations with the primary outcome. The area under the receiver operating characteristic curve (AUC) was 0.864, which is significantly higher than that with SIRS, where the AUC was 0.786 (P < 0.01). Conclusions: The qSOFA score potentially is a useful prognostic predictor for influenza and could be applied in the ED as a risk stratification tool. However, qSOFA may not be a good screening tool for triage because of its poor sensitivity. The SIRS criteria showed poor predictive performance in influenza for mortality as an outcome. Further research is needed to determine the role of these predictive tools in influenza and in other viral infections.

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Mortality and severity evaluation by routine pneumonia prediction models among Japanese patients with 2009 pandemic influenza A (H1N1) pneumonia

Abstract: CURB-65 and A-DROP are fair predictors of mortality regardless of pneumonia patterns. However, the current pneumonia prediction models may underestimate the severity and appropriate site of care for patients with influenza pneumonia.

Cited by 14 publications

References 29 publications

Recovery of pulmonary functions, exercise capacity, and quality of life after pulmonary rehabilitation in survivors of ARDS due to severe influenza A (H1N1) pneumonitis

Recovery of pulmonary functions, exercise capacity, and quality of life after pulmonary rehabilitation in survivors of ARDS due to severe influenza A (H1N1) pneumonitis

Mortality prediction to hospitalized patients with influenza pneumonia: PO₂/FiO₂ combined lymphocyte count is the answer

Prognostic accuracy of SIRS criteria and qSOFA score for in-hospital mortality among influenza patients in the emergency department

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Mortality and severity evaluation by routine pneumonia prediction models among Japanese patients with 2009 pandemic influenza A (H1N1) pneumonia

Abstract: CURB-65 and A-DROP are fair predictors of mortality regardless of pneumonia patterns. However, the current pneumonia prediction models may underestimate the severity and appropriate site of care for patients with influenza pneumonia.

Cited by 14 publications

References 29 publications

Recovery of pulmonary functions, exercise capacity, and quality of life after pulmonary rehabilitation in survivors of ARDS due to severe influenza A (H1N1) pneumonitis

Recovery of pulmonary functions, exercise capacity, and quality of life after pulmonary rehabilitation in survivors of ARDS due to severe influenza A (H1N1) pneumonitis

Mortality prediction to hospitalized patients with influenza pneumonia: PO2/FiO2 combined lymphocyte count is the answer

Prognostic accuracy of SIRS criteria and qSOFA score for in-hospital mortality among influenza patients in the emergency department

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Mortality prediction to hospitalized patients with influenza pneumonia: PO₂/FiO₂ combined lymphocyte count is the answer