Predicting Need for Hospitalization of Patients with Pandemic (H1N1) 2009, Chicago, Illinois, USA

Vasoo, Shawn; Singh, Kamaljit; Trenholme, Gordon M.

doi:10.3201/eid1610.091889

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…Other studies have also demonstrated that hypoxia or requirement for oxygen was also an important risk factor for hospitalization or ICU admission [31,32], which we found in our bivariable analyses for influenza-confirmed infection, but after adjusting for other important covariates, this was no longer significant. Our study suggests that respiratory rate is a more reliable predictor of influenza severity than oxygen saturation in children, but our findings may be difficult to interpret since the effects of higher altitude in Colorado may have impacted the interpretation of oxygen saturation in this study [33][34][35].…”

Section: Plos Onesupporting

confidence: 53%

Vital sign predictors of severe influenza among children in an emergent care setting

et al. 2022

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Background Decisions regarding the evaluation of children with influenza infection rely on the likelihood of severe disease. The role of early vital signs as predictors of severe influenza infection in children is not well known. Our objectives were to determine the value of vital signs in predicting hospitalization/recurrent emergency department (ED) visits due to influenza infection in children. Methods We conducted a prospective study of children aged 6 months to 8 years of age with influenza like illness evaluated at an ED/UC from 2016–2018. All children underwent influenza testing by PCR. We collected heart rate, respiratory rate and temperature, and converted heart rate (HR) and respiratory rate (RR) to z-scores by age. HR z scores were further adjusted for temperature. Our primary outcome was hospitalization/recurrent ED visits within 72 hours. Vital sign predictors with p< 0.2 and other clinical covariates were entered into a multivariable logistic regression model to determine odds ratios (OR) and 95% CI; model performance was assessed using the Brier score and discriminative ability with the C statistic. Results Among 1478 children, 411 (27.8%) were positive for influenza, of which 42 (10.2%) were hospitalized or had a recurrent ED visit. In multivariable analyses, adjusting for age, high-risk medical condition and school/daycare attendance, higher adjusted respiratory rate (OR 2.09, 95%CI 1.21–3.61, p = 0.0085) was a significant predictor of influenza hospitalization/recurrent ED visits. Conclusions Higher respiratory rate adjusted for age was the most useful vital sign predictor of severity among young children with PCR-confirmed influenza.

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Section: Plos Onesupporting

confidence: 53%

Vital sign predictors of severe influenza among children in an emergent care setting

et al. 2022

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“…Among 2–19 year patients (n = 200), hospitalization was associated with being underweight (BMI< = 5th percentile). Morbid obesity was also found to be associated with hospitalization by pandemic influenza [23] , [38] – [40] but Vasoo et al [41] and Gilca et al [22] did not find obesity to be a significant factor for hospitalization.…”

Section: Discussionmentioning

confidence: 96%

Sociodemographic Factors and Clinical Conditions Associated to Hospitalization in Influenza A (H1N1) 2009 Virus Infected Patients in Spain, 2009–2010

et al. 2012

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The emergence and pandemic spread of a new strain of influenza A (H1N1) virus in 2009 resulted in a serious alarm in clinical and public health services all over the world. One distinguishing feature of this new influenza pandemic was the different profile of hospitalized patients compared to those from traditional seasonal influenza infections. Our goal was to analyze sociodemographic and clinical factors associated to hospitalization following infection by influenza A(H1N1) virus. We report the results of a Spanish nationwide study with laboratory confirmed infection by the new pandemic virus in a case-control design based on hospitalized patients. The main risk factors for hospitalization of influenza A (H1N1) 2009 were determined to be obesity (BMI≥40, with an odds-ratio [OR] 14.27), hematological neoplasia (OR 10.71), chronic heart disease, COPD (OR 5.16) and neurological disease, among the clinical conditions, whereas low education level and some ethnic backgrounds (Gypsies and Amerinds) were the sociodemographic variables found associated to hospitalization. The presence of any clinical condition of moderate risk almost triples the risk of hospitalization (OR 2.88) and high risk conditions raise this value markedly (OR 6.43). The risk of hospitalization increased proportionally when for two (OR 2.08) or for three or more (OR 4.86) risk factors were simultaneously present in the same patient. These findings should be considered when a new influenza virus appears in the human population.

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“…A preliminary report of 32 patients with influenza A (H1N1) 2009 virus infection hospitalized in a Spanish ICU showed that pneumonia was associated with a relatively high case-fatality rate [28]. The rate of patients hospitalized in wards and the ICU with pneumonia in the 2009 pandemic was higher [3,4,8,19,29]. We sought to confirm that pneumonia was an independent risk factor for SIHC.…”

Section: Discussionmentioning

confidence: 98%

Score to identify the severity of adult patients with influenza A (H1N1) 2009 virus infection at hospital admission

Capelastegui

Quintana

Bilbao

et al. 2012

Eur J Clin Microbiol Infect Dis

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The objective of this paper was to develop a prognostic index for severe complications among hospitalized patients with influenza A (H1N1) 2009 virus infection. We conducted a prospective observational cohort study of 618 inpatients with 2009 H1N1 virus infection admitted to 36 Spanish hospitals between July 2009 and February 2010. Risk factors evaluated included host-related factors and clinical data at admission. We developed a composite index of severe in-hospital complications (SIHC), which included: mortality, mechanical ventilation, septic shock, acute respiratory distress syndrome, and requirement for resuscitation maneuvers. Six factors were independently associated with SIHC: age >45 years, male sex, number of comorbidities, pneumonia, dyspnea, and confusion. From the β parameter obtained in the multivariate model, a weight was assigned to each factor to compute the individual influenza risk score. The score shows an area under the receiver operating characteristic (ROC) curve of 0.77. The SIHC rate was 1.9 % in the low-risk group, 10.3 % in the intermediate-risk group, and 29.6 % in the high-risk group. The odds ratio for complications was 21.8 for the high-risk group compared with the low-risk group. This easy-to-score influenza A (H1N1) 2009 virus infection risk index accurately stratifies patients hospitalized for H1N1 virus infection into low-, intermediate-, and high-risk groups for SIHC.

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Predicting Need for Hospitalization of Patients with Pandemic (H1N1) 2009, Chicago, Illinois, USA

Cited by 5 publications

References 7 publications

Vital sign predictors of severe influenza among children in an emergent care setting

Vital sign predictors of severe influenza among children in an emergent care setting

Sociodemographic Factors and Clinical Conditions Associated to Hospitalization in Influenza A (H1N1) 2009 Virus Infected Patients in Spain, 2009–2010

Score to identify the severity of adult patients with influenza A (H1N1) 2009 virus infection at hospital admission

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