General Characteristics and Prognostic Factors of Pneumonia Cases Developed During Pandemic (H1N1) Influenza-A Virus Infection in Turkey

General Characteristics and Prognostic Factors of Pneumonia Cases Developed During Pandemic (H1N1) Influenza-A Virus Infection in Turkey

Objective: Unlike seasonal influenza, seen in previous years, the strain identified in the 2009 influenza-A pandemic involved high mortality. In this study, prognostic factors and general characteristics of pneumonia cases developed in Turkey during the H1N1 pandemic between October 2009 and January 2010 were analyzed. Study Design: Multicenter retrospective study. Material and Methods: This multicentric retrospective study was conducted between August and October 2010 and patients' data were collected by means of standard forms. Results: The study included 264 pneumonia cases, collected from 14 different centers. Mean age was 47.5±18.6 years. Nineteen patients (7.2%) were pregnant or had a new birth and comorbid diseases were detected in 52.3% of all patients. On admission, 35 (13.8%) cases had altered mental status. Overall, 32.6% were treated in intensive care units (ICU) and invasive/non-invasive mechanical ventilation was performed in 29.7%. The mean duration of ICU stay was 2.9±6.2 and total hospital stay was 12.0±9.4 days. Mortality rate was 16.8% (43-cases). The length of ICU treatment, total hospital stay, and mortality were significantly higher in H1N1-confirmed patients. Mortality was significantly higher in patients with dyspnea, cyanosis, and those who had altered mental status on admission. Patients who died had significantly higher rate of peripheral blood neutrophils, lower platelet counts, higher BUN, and lower SaO2 levels. Conclusion: This study showed that pneumonia developed during H1N1 pandemic in our country had resulted in a high mortality. Mortality was especially high among patients with cyanosis, altered mental state and those with lower SaO2. Turkish Başlık: Türkiye'de Pandemik İnfluenza A (H1N1) Salgını Sırasında Pnömoni Gelişen Olguların Genel Özellikleri ve Prognostik Faktörler Anahtar Kelimeler: İnfluenza, Pandemik influenza A, H1N1 pandemisi, mortalite pnömoni, yoğun bakım ünitesi Amaç: Önceki yıllarda gelişen mevsimsel influenza olgularından farklı olarak, 2009 yılında görülen pandemik influenza-A enfeksiyonu yüksek oranda mortal seyretmiştir. Bu çalışmada, Ekim-2009 ile Ocak-2010 tarihleri arasında ülkemizde görülen pandemik influenza A (H1N1) salgını sırasında pnömoni gelişen olguların genel özellikleri ve ilişkili prognostik faktörleri analiz edilmiştir. Gereç ve Yöntemler: Hasta bilgilerinin standart veri formları aracılığı ile toparlandığı bu çalışma, çok merkezli olarak Ağustos-Ekim 2010 tarihleri arasında gerçekleştirilmiştir. Bulgular: Çalışmaya 14 merkezden toplam 264 olgu alındı. Hastaların ortalama yaşları 47.5±18.6 yıl idi. Hastaların 19'u (%7.2) gebe veya yeni doğum yapmıştı. Başvuru sırasında hastaların %52.3'ünde komorbid bir hastalık, %13.8'inde ise (35 hasta) şuur değişikliği mevcuttu. Hastaların %32.6'sı yoğun bakım ünitesinde (YBÜ) takip edilmiş, tüm olguların %29.7'sinde invaziv ya da non-invaziv mekanik ventilasyon uygulanmıştı. YBÜ'de yatış süresi 2.9±6.2 gün, hastanede toplam yatış süresi ise 12.0±9.4 gündü. Mortalite oranı %16.8 (43-olgu) bulundu. YBÜ'de kalış süresi, toplam yatış süresi ve mortalite; H1N1 teyid edilen hastalarda anlamlı fazlaydı. Başvuru sırasında dispnesi, siyanozlu ve şuur değişikliği olan hastalarda mortalite anlamlı yüksekti. Ölen olgularda ayrıca periferik kan nötrofil oranları yüksek, trombosit sayıları düşük, BUN düzeyi yüksek ve SaO2 düzeyi anlamlı düşük bulundu. Sonuç: Çalışmamız, ülkemizde yaşanan H1N1 salgını sırasında gelişen pnömonilerin yüksek mortalite ile sonuçlandığını göstermiştir. Özellikle siyanozlu, şuur değişikliği olan ve oksijen saturasyonu düşük olan hastalarda mortalite anlamlı yüksek seyretmiştir.

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Balkan Medical Journal-Cover
  • ISSN: 2146-3123
  • Başlangıç: 2015
  • Yayıncı: Erkan Mor
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