Dataset Information

Mortality prediction to hospitalized patients with influenza pneumonia: PO₂ /FiO₂ combined lymphocyte count is the answer.

ABSTRACT:

Introduction

Community-acquired pneumonia (CAP) severity scores perform well in predicting mortality of CAP patients, but their applicability in influenza pneumonia is powerless.

Objectives

The aim of our research was to test the efficiency of PO₂ /FiO₂ and CAP severity scores in predicting mortality and intensive care unit (ICU) admission with influenza pneumonia patients.

Methods

We reviewed all patients with positive influenza virus RNA detection in Beijing Chao-Yang Hospital during the 2009-2014 influenza seasons. Outpatients, inpatients with no pneumonia and incomplete data were excluded. We used receiver operating characteristic curves (ROCs) to verify the accuracy of severity scores or indices as mortality predictors in the study patients.

Results

Among 170 hospitalized patients with influenza pneumonia, 30 (17.6%) died. Among those who were classified as low-risk (predicted mortality 0.1%-2.1%) by pneumonia severity index (PSI) or confusion, urea, respiratory rate, blood pressure, age ?65 year (CURB-65), the actual mortality ranged from 5.9 to 22.1%. Multivariate logistic regression indicated that hypoxia (PO₂ /FiO₂ ???250) and lymphopenia (peripheral blood lymphocyte count <0.8 × 10⁹ /L) were independent risk factors for mortality, with OR value of 22.483 (95% confidence interval 4.927-102.598) and 5.853 (95% confidence interval 1.887-18.152), respectively. PO₂ /FiO₂ combined lymphocyte count performed well for mortality prediction with area under the curve (AUC) of 0.945, which was significantly better than current CAP severity scores of PSI, CURB-65 and confusion, respiratory rate, blood pressure, age ?65 years for mortality prediction (P?2 /FiO₂ combined lymphocyte count was also the best predictor for predicting ICU admission.

Conclusion

In conclusion, we found that PO₂ /FiO₂ combined lymphocyte count is simple and reliable predictor of hospitalized patients with influenza pneumonia in predicting mortality and ICU admission. When PO₂ /FiO₂ ???250 or peripheral blood lymphocyte count <0.8 × 10⁹ /L, the clinician should pay great attention to the possibility of severe influenza pneumonia.

SUBMITTER: Shi SJ

PROVIDER: S-EPMC7162301 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

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Publications

Mortality prediction to hospitalized patients with influenza pneumonia: PO<sub>2</sub> /FiO<sub>2</sub> combined lymphocyte count is the answer.

Shi Shu Jing SJ Li Hui H Liu Meng M Liu Ying Mei YM Zhou Fei F Liu Bo B Qu Jiu Xin JX Cao Bin B

The clinical respiratory journal 20150811 3

<h4>Introduction</h4>Community-acquired pneumonia (CAP) severity scores perform well in predicting mortality of CAP patients, but their applicability in influenza pneumonia is powerless.<h4>Objectives</h4>The aim of our research was to test the efficiency of PO<sub>2</sub> /FiO<sub>2</sub> and CAP severity scores in predicting mortality and intensive care unit (ICU) admission with influenza pneumonia patients.<h4>Methods</h4>We reviewed all patients with positive influenza virus RNA detection in ...[more]

PMID: 26148709

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Project description:IntroductionThe point-of-care lung ultrasound (LUS) score has been used in coronavirus 2019 (COVID-19) patients for diagnosis and risk stratification, due to excellent sensitivity and infection control concerns. We studied the ratio of partial pressure of oxygen in arterial blood to the fraction of inspiratory oxygen concentration (PO2/FiO2), intubation rates, and mortality correlation to the LUS score.MethodsWe conducted a systematic review using PRISMA guidelines. Included were articles published from December 1, 2019-November 30, 2021 using LUS in adult COVID-19 patients in the intensive care unit or the emergency department. Excluded were studies on animals and on pediatric and pregnant patients. We assessed bias using QUADAS-2. Outcomes were LUS score and correlation to PO2/FiO2, intubation, and mortality rates. Random effects model pooled the meta-analysis results.ResultsWe reviewed 27 of 5,267 studies identified. Of the 27 studies, seven were included in the intubation outcome, six in the correlation to PO2/FiO2 outcome, and six in the mortality outcome. Heterogeneity was found in ultrasound protocols and outcomes. In the pooled results of 267 patients, LUS score was found to have a strong negative correlation to PO2/FiO2 with a correlation coefficient of -0.69 (95% confidence interval [CI] -0.75, -0.62). In pooled results, 273 intubated patients had a mean LUS score that was 6.95 points higher (95% CI 4.58-9.31) than that of 379 non-intubated patients. In the mortality outcome, 385 survivors had a mean LUS score that was 4.61 points lower (95% CI 3.64-5.58) than that of 181 non-survivors. There was significant heterogeneity between the studies as measured by the I2 and Cochran Q test.ConclusionA higher LUS score was strongly correlated with a decreasing PO2/FiO2 in COVID-19 pneumonia patients. The LUS score was significantly higher in intubated vs non-intubated patients with COVID-19. The LUS score was significantly lower in critically ill patients with COVID-19 pneumonia that survive.

Project description:BACKGROUND:Pneumonia is one of the most common complications in children hospitalized with influenza. We describe hospitalized children with influenza-associated pneumonia and associated risk indicators. METHODS:Through Emerging Infections Program Network population based surveillance, children aged <18 years hospitalized with laboratory confirmed influenza with a chest radiograph during hospitalization were identified during the 2003-2008 influenza seasons. A case with radiologically confirmed influenza-associated pneumonia was defined as a child from the surveillance area hospitalized with: (1) laboratory-confirmed influenza and (2) evidence of new pneumonia on chest radiograph during hospitalization. Hospitalized children with pneumonia were compared with those without pneumonia by univariate and multivariate analysis. RESULTS:Overall, 2992 hospitalized children with influenza with a chest radiograph were identified; 1072 (36%) had influenza-associated pneumonia.When compared with children hospitalized with influenza without pneumonia, hospitalized children with influenza-associated pneumonia were more likely to require intensive care unit admission (21% vs. 11%, P < 0.01), develop respiratory failure (11% versus 3%, P < 0.01), and die(0.9% vs. 0.3% P 0.01). In multivariate analysis, age 6 to 23 months(adjusted OR: 2.1, CI: 1.6 -2.8), age 2 to 4 years (adjusted OR: 1.7, CI:1.3-2.2), and asthma (adjusted OR: 1.4, CI: 1.1-1.8) were significantly associated with influenza-associated pneumonia. CONCLUSIONS:Hospitalized children with influenza-associated pneumonia were more likely to have a severe clinical course than other hospitalized children with influenza, and children aged 6 months to 4 years and those with asthma were more likely to have influenza-associated pneumonia.Identifying children at greater risk for influenza-associated pneumonia will inform prevention and treatment strategies targeting children at risk for influenza complications.

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Dataset Information

Mortality prediction to hospitalized patients with influenza pneumonia: PO₂ /FiO₂ combined lymphocyte count is the answer.

Introduction

Objectives

Methods

Results

Conclusion

Publications

Mortality prediction to hospitalized patients with influenza pneumonia: PO<sub>2</sub> /FiO<sub>2</sub> combined lymphocyte count is the answer.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

Mortality prediction to hospitalized patients with influenza pneumonia: PO2 /FiO2 combined lymphocyte count is the answer.

Introduction

Objectives

Methods

Results

Conclusion

Publications

Mortality prediction to hospitalized patients with influenza pneumonia: PO<sub>2</sub> /FiO<sub>2</sub> combined lymphocyte count is the answer.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Mortality prediction to hospitalized patients with influenza pneumonia: PO₂ /FiO₂ combined lymphocyte count is the answer.