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Free Content Clinical characteristics and outcomes of H1N1-associated pneumonia among adults in South Korea

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Abstract:

BACKGROUND: Pneumonia has been reported to be the most life-threatening complication of influenza virus infection.

OBJECTIVE: To describe clinical characteristics and determine risk factors for death among patients with H1N1-associated pneumonia.

DESIGN: A retrospective cohort study included all adult patients diagnosed and treated with H1N1-associated pneumonia in 14 participating institutions between 1 May 2009 and 28 February 2010 in South Korea. Clinical outcomes were summarised and predictors for death evaluated through univariate and multivariate analysis.

RESULTS: A total of 269 adult patients with H1N1-associated pneumonia were diagnosed and treated. Hospital visits or admissions peaked in November 2009, coinciding with the peak in the 2009 H1N1 epidemic in South Korea. The patients' median age was 48 years; 143 were male. Most (n = 266, 98.9%) were admitted for treatment: 97 (36.1%) required intensive care and 28 (10.4%) needed mechanical ventilation. Despite the use of antiviral and antibacterial agents, 19 patients (7.1%) died. Risk factors predictive of death included presence of malignancy (aOR 12.0, 95%CI 2.8–51.5), and pneumonia severity index (PSI) score (aOR 1.03, 95%CI 1.01–1.04).

CONCLUSION: Deaths among adult patients with H1N1-associated pneumonia were not rare. Clinicians should be aware of the possibility of a poor prognosis among H1N1-associated pneumonia patients with underlying malignancy or high PSI score.

Keywords: H1N1 influenza; outcome; pneumonia

Document Type: Regular Paper

Affiliations: 1: Department of Internal Medicine, Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea 2: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Republic of Korea 3: School of Media, Seoul Women's University, Seoul, Republic of Korea 4: Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea 5: Department of Internal Medicine, Konyang University Hospital, Daejeon, Republic of Korea 6: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea 7: Department of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea 8: Department of Pulmonary and Critical Care Medicine, Dongguk University Gyeongju Hospital, Gyeongju, Republic of Korea 9: Division of Pulmonary, Allergy, and Critical Care Medicine of Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea 10: Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, Republic of Korea 11: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea 12: Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Gyeonggi-do, Republic of Korea 13: Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea 14: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government, Seoul National University Boramae Medical Center, Seoul, Republic of Korea 15: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Republic of Korea

Publication date: February 1, 2011

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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