Predicting mortality in hospitalized patients with 2009 H1N1 influenza pneumonia

R. Riquelme, P. Jiménez, A. J. Videla, H. Lopez, J. Chalmers, A. Singanayagam, M. Riquelme, P. Peyrani, T. Wiemken, G. Arbo, G. Benchetrit, M. L. Rioseco, K. Ayesu, A. Klotchko, L. Marzoratti, M. Raya, S. Figueroa, F. Saavedra, D. Pryluka, C. InzunzaA. Torres, P. Alvare, P. Fernandez, M. Barros, Y. Gomez, C. Contreras, J. Rello, J. Bordon, C. Feldman, F. Arnold, R. Nakamatsu, J. Riquelme, F. Blasi, S. Aliberti, R. Cosentini, G. Lopardo, M. Gnoni, T. Welte, M. Saad, J. Guardiola, Julio Ramirez

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Community-acquired pneumonia (CAP) severity scores can identify patients at low risk for mortality who may be suitable for ambulatory care. Here, we follow the clinical course of hospitalized patients with CAP due to 2009 H1N1 influenza. OBJECTIVE: To evaluate the role of CAP severity scores as predictors of mortality. METHODS: This was a secondary data analysis of patients hospitalized with CAP due to 2009 H1N1 influenza confirmed by reverse transcriptase polymerase chain reaction enrolled in the CAPO (Community-Acquired Pneumonia Organization) international cohort study. CAP severity scores PSI (Pneumonia Severity Index), CURB-65 (confusion, urea, respiratory rate, blood pressure, age ≥ 65 years) and CRB-65 (confusion, respiratory rate, blood pressure, age ≥ 65 years) were calculated. Actual and predicted mortality rates were compared. A total of 37 predictor variables were evaluated to define those associated with mortality. RESULTS: Data from 250 patients with CAP due to 2009 H1N1 influenza were analyzed. Patients with low predicted mortality rates (0-1.5%) had actual mortality rates ranging from 2.6% to 17.5%. Obesity and wheezing were the only novel variables associated with mortality. CONCLUSIONS: The decision to hospitalize a patient with CAP due to 2009 H1N1 influenza should not be based on current CAP severity scores, as they underestimate mortality rates in a significant number of patients. Patients with obesity or wheezing should be considered at an increased risk for mortality.

Original languageEnglish
Pages (from-to)542-546
Number of pages5
JournalInternational Journal of Tuberculosis and Lung Disease
Volume15
Issue number4
DOIs
Publication statusPublished - Apr 2011

Keywords

  • H1N1
  • Influenza
  • Mortality
  • Pneumonia
  • Severity score

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

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    Riquelme, R., Jiménez, P., Videla, A. J., Lopez, H., Chalmers, J., Singanayagam, A., Riquelme, M., Peyrani, P., Wiemken, T., Arbo, G., Benchetrit, G., Rioseco, M. L., Ayesu, K., Klotchko, A., Marzoratti, L., Raya, M., Figueroa, S., Saavedra, F., Pryluka, D., ... Ramirez, J. (2011). Predicting mortality in hospitalized patients with 2009 H1N1 influenza pneumonia. International Journal of Tuberculosis and Lung Disease, 15(4), 542-546. https://doi.org/10.5588/ijtld.10.0539