Factors associated with death of severe cases of influenza A(H1N1)pdm09

Abstract Introduction the first influenza pandemic of the 21st century occurred in 2009, caused by the new subtype of influenza virus, influenza A (H1N1) pdm09. Objective to analyze the factors associated with death due to Severe Acute Respiratory Infection (SARI) caused by influenza A (H1N1) pdm09 in residents of the city of Rio de Janeiro. Method Analysis of secondary data, including 1,191 confirmed cases of influenza A (H1N1) pdm09 with clinical criteria for SARI, residents of the city of Rio de Janeiro, in 2009. Descriptive statistical analysis and logistic regression for the study of factors associated with death. Results 60.3% occurred in women, with 185 pregnant women; 48.1% in children under 20 years old; 35.7% had comorbidities; 91.4% were hospitalized, and 7.4% died. There was a higher chance of death associated with low educational level, presence of comorbidity, radiological pattern of interstitial infiltrate, consolidation or mixed; laboratory confirmation; vaccination status ignored. Conclusion individuals with low educational level who had at least one comorbidity and had pulmonary involvement with a radiological pattern with interstitial infiltrate, consolidation or mixed had a higher chance of dying. Knowledge of this profile allows for more efficient planning of health care.

摘要 引言：21世纪首次流感大流行于2009年暴发，由新型流感病毒亚型甲型流感（H1N1）pdm09（Influenza A (H1N1) pdm09）引发。
本研究旨在分析里约热内卢市居民感染甲型流感（H1N1）pdm09所致重症急性呼吸道感染（Severe Acute Respiratory Infection, SARI）的死亡相关影响因素。
方法 本研究采用二手数据分析方法，纳入2009年里约热内卢市1191例经实验室确认的甲型流感（H1N1）pdm09感染且符合重症急性呼吸道感染临床诊断标准的居民病例。通过描述性统计分析及logistic回归分析，探究与死亡结局相关的影响因素。
结果 本研究队列中60.3%为女性，其中包含185名妊娠女性；48.1%为20岁以下儿童；35.7%的患者存在合并症；91.4%的患者接受了住院治疗，总体病死率为7.4%。分析显示，低受教育水平、合并基础疾病、影像学表现为间质性浸润、实变或混合性肺部病变、经实验室确诊以及疫苗接种情况不明，均与死亡风险升高显著相关。
结论 低受教育水平、合并至少一种基础疾病，且影像学提示肺部受累伴间质性浸润、实变或混合性病变的感染者，死亡风险显著升高。明确该高危人群特征，可助力更高效地规划医疗救治与健康管理工作。