Determinants of Fatal Outcome in Patients Admitted to Intensive Care Units With Influenza, European Union 2009–2017
Open Access
- 29 October 2019
- journal article
- research article
- Published by Oxford University Press (OUP) in Open Forum Infectious Diseases
- Vol. 6 (11), ofz462
- https://doi.org/10.1093/ofid/ofz462
Abstract
Morbidity, severity, and mortality associated with annual influenza epidemics are of public health concern. We analyzed surveillance data on hospitalized laboratory-confirmed influenza cases admitted to intensive care units to identify common determinants for fatal outcome and inform and target public health prevention strategies, including risk communication. We performed a descriptive analysis and used Poisson regression models with robust variance to estimate the association of age, sex, virus (sub)type, and underlying medical condition with fatal outcome using European Union data from 2009 to 2017. Of 13 368 cases included in the basic dataset, 2806 (21%) were fatal. Age ≥40 years and infection with influenza A virus were associated with fatal outcome. Of 5886 cases with known underlying medical conditions and virus A subtype included in a more detailed analysis, 1349 (23%) were fatal. Influenza virus A(H1N1)pdm09 or A(H3N2) infection, age ≥60 years, cancer, human immunodeficiency virus infection and/or other immune deficiency, and heart, kidney, and liver disease were associated with fatal outcome; the risk of death was lower for patients with chronic lung disease and for pregnant women. This study re-emphasises the importance of preventing influenza in the elderly and tailoring strategies to risk groups with underlying medical conditions.Keywords
Funding Information
- European Centre for Disease Prevention and Control
This publication has 29 references indexed in Scilit:
- Severe Influenza-associated Respiratory Infection in High HIV Prevalence Setting, South Africa, 2009–2011Emerging Infectious Diseases, 2013
- Differences between asthmatics and nonasthmatics hospitalised with influenza A infectionEuropean Respiratory Journal, 2013
- Influenza-Related Mortality Among Adults Aged 25–54 Years With AIDS in South Africa and the United States of AmericaClinical Infectious Diseases, 2012
- Risk Factors for Severe Outcomes following 2009 Influenza A (H1N1) Infection: A Global Pooled AnalysisPLoS Medicine, 2011
- Pandemic and post-pandemic Influenza A (H1N1) infection in critically ill patientsCritical Care, 2011
- Emerging Influenza Antiviral Resistance ThreatsThe Journal of Infectious Diseases, 2011
- Influenza surveillance in EuropeEuropean Journal of Public Health, 2010
- Preliminary Estimates of Mortality and Years of Life Lost Associated with the 2009 A/H1N1 Pandemic in the US and Comparison with Past Influenza SeasonsPLoS Currents, 2010
- Is routine influenza immunization warranted in early pregnancy?Vaccine, 2009
- Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratioBMC Medical Research Methodology, 2003