Severity of influenza A 2009 (H1N1) pneumonia is underestimated by routine prediction rules. Results from a prospective, population-based study.
Characteristics of patients with community-acquired pneumonia (CAP) due to pandemic influenza A 2009 (H1N1) have been inadequately compared to CAP caused by other respiratory pathogens. The performance of prediction rules for CAP during an epidemic with a new infectious agent are unknown. Prospectiv...
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Online Access: | http://hdl.handle.net/2336/295220 https://doi.org/10.1371/journal.pone.0046816 |
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ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/295220 2023-05-15T16:49:39+02:00 Severity of influenza A 2009 (H1N1) pneumonia is underestimated by routine prediction rules. Results from a prospective, population-based study. Bjarnason, Agnar Thorleifsdottir, Gudlaug Löve, Arthur Gudnason, Janus F Asgeirsson, Hilmir Hallgrimsson, Kristinn L Kristjansdottir, Berglind S Haraldsson, Gunnsteinn Baldursson, Olafur Kristinsson, Karl G Gottfredsson, Magnus Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 2013-07-04 http://hdl.handle.net/2336/295220 https://doi.org/10.1371/journal.pone.0046816 en eng http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3469650/ PLoS ONE 2012, 7(10):e46816 1932-6203 23071646 doi:10.1371/journal.pone.0046816 http://hdl.handle.net/2336/295220 PloS one Archived with thanks to PloS one Open Access - Opinn aðgangur Adult Aged Anti-Bacterial Agents Antiviral Agents Coinfection Community-Acquired Infections Comorbidity Female Humans Iceland Influenza A Virus H1N1 Subtype Influenza Human Intensive Care Units Length of Stay Male Middle Aged Mycoplasma pneumoniae Oseltamivir Pandemics Patient Admission Pneumonia Bacterial Prospective Studies Severity of Illness Index Streptococcus pneumoniae Article 2013 ftlandspitaliuni https://doi.org/10.1371/journal.pone.0046816 2022-05-29T08:21:51Z Characteristics of patients with community-acquired pneumonia (CAP) due to pandemic influenza A 2009 (H1N1) have been inadequately compared to CAP caused by other respiratory pathogens. The performance of prediction rules for CAP during an epidemic with a new infectious agent are unknown. Prospective, population-based study from November 2008-November 2009, in centers representing 70% of hospital beds in Iceland. Patients admitted with CAP underwent evaluation and etiologic testing, including polymerase chain reaction (PCR) for influenza. Data on influenza-like illness in the community and overall hospital admissions were collected. Clinical and laboratory data, including pneumonia severity index (PSI) and CURB-65 of patients with CAP due to H1N1 were compared to those caused by other agents. Of 338 consecutive and eligible patients 313 (93%) were enrolled. During the pandemic peak, influenza A 2009 (H1N1) patients constituted 38% of admissions due to CAP. These patients were younger, more dyspnoeic and more frequently reported hemoptysis. They had significantly lower severity scores than other patients with CAP (1.23 vs. 1.61, P= .02 for CURB-65, 2.05 vs. 2.87 for PSI, P<.001) and were more likely to require intensive care admission (41% vs. 5%, P<.001) and receive mechanical ventilation (14% vs. 2%, P= .01). Bacterial co-infection was detected in 23% of influenza A 2009 (H1N1) patients with CAP. Clinical characteristics of CAP caused by influenza A 2009 (H1N1) differ markedly from CAP caused by other etiologic agents. Commonly used CAP prediction rules often failed to predict admissions to intensive care or need for assisted ventilation in CAP caused by the influenza A 2009 (H1N1) virus, underscoring the importance of clinical acumen under these circumstances. Icelandic Center for Research, Rannis 100436021 Landspitali University Hospital Science Fund Article in Journal/Newspaper Iceland Hirsla - Landspítali University Hospital research archive Psi ENVELOPE(-63.000,-63.000,-64.300,-64.300) PLoS ONE 7 10 e46816 |
institution |
Open Polar |
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Hirsla - Landspítali University Hospital research archive |
op_collection_id |
ftlandspitaliuni |
language |
English |
topic |
Adult Aged Anti-Bacterial Agents Antiviral Agents Coinfection Community-Acquired Infections Comorbidity Female Humans Iceland Influenza A Virus H1N1 Subtype Influenza Human Intensive Care Units Length of Stay Male Middle Aged Mycoplasma pneumoniae Oseltamivir Pandemics Patient Admission Pneumonia Bacterial Prospective Studies Severity of Illness Index Streptococcus pneumoniae |
spellingShingle |
Adult Aged Anti-Bacterial Agents Antiviral Agents Coinfection Community-Acquired Infections Comorbidity Female Humans Iceland Influenza A Virus H1N1 Subtype Influenza Human Intensive Care Units Length of Stay Male Middle Aged Mycoplasma pneumoniae Oseltamivir Pandemics Patient Admission Pneumonia Bacterial Prospective Studies Severity of Illness Index Streptococcus pneumoniae Bjarnason, Agnar Thorleifsdottir, Gudlaug Löve, Arthur Gudnason, Janus F Asgeirsson, Hilmir Hallgrimsson, Kristinn L Kristjansdottir, Berglind S Haraldsson, Gunnsteinn Baldursson, Olafur Kristinsson, Karl G Gottfredsson, Magnus Severity of influenza A 2009 (H1N1) pneumonia is underestimated by routine prediction rules. Results from a prospective, population-based study. |
topic_facet |
Adult Aged Anti-Bacterial Agents Antiviral Agents Coinfection Community-Acquired Infections Comorbidity Female Humans Iceland Influenza A Virus H1N1 Subtype Influenza Human Intensive Care Units Length of Stay Male Middle Aged Mycoplasma pneumoniae Oseltamivir Pandemics Patient Admission Pneumonia Bacterial Prospective Studies Severity of Illness Index Streptococcus pneumoniae |
description |
Characteristics of patients with community-acquired pneumonia (CAP) due to pandemic influenza A 2009 (H1N1) have been inadequately compared to CAP caused by other respiratory pathogens. The performance of prediction rules for CAP during an epidemic with a new infectious agent are unknown. Prospective, population-based study from November 2008-November 2009, in centers representing 70% of hospital beds in Iceland. Patients admitted with CAP underwent evaluation and etiologic testing, including polymerase chain reaction (PCR) for influenza. Data on influenza-like illness in the community and overall hospital admissions were collected. Clinical and laboratory data, including pneumonia severity index (PSI) and CURB-65 of patients with CAP due to H1N1 were compared to those caused by other agents. Of 338 consecutive and eligible patients 313 (93%) were enrolled. During the pandemic peak, influenza A 2009 (H1N1) patients constituted 38% of admissions due to CAP. These patients were younger, more dyspnoeic and more frequently reported hemoptysis. They had significantly lower severity scores than other patients with CAP (1.23 vs. 1.61, P= .02 for CURB-65, 2.05 vs. 2.87 for PSI, P<.001) and were more likely to require intensive care admission (41% vs. 5%, P<.001) and receive mechanical ventilation (14% vs. 2%, P= .01). Bacterial co-infection was detected in 23% of influenza A 2009 (H1N1) patients with CAP. Clinical characteristics of CAP caused by influenza A 2009 (H1N1) differ markedly from CAP caused by other etiologic agents. Commonly used CAP prediction rules often failed to predict admissions to intensive care or need for assisted ventilation in CAP caused by the influenza A 2009 (H1N1) virus, underscoring the importance of clinical acumen under these circumstances. Icelandic Center for Research, Rannis 100436021 Landspitali University Hospital Science Fund |
author2 |
Faculty of Medicine, University of Iceland, Reykjavik, Iceland. |
format |
Article in Journal/Newspaper |
author |
Bjarnason, Agnar Thorleifsdottir, Gudlaug Löve, Arthur Gudnason, Janus F Asgeirsson, Hilmir Hallgrimsson, Kristinn L Kristjansdottir, Berglind S Haraldsson, Gunnsteinn Baldursson, Olafur Kristinsson, Karl G Gottfredsson, Magnus |
author_facet |
Bjarnason, Agnar Thorleifsdottir, Gudlaug Löve, Arthur Gudnason, Janus F Asgeirsson, Hilmir Hallgrimsson, Kristinn L Kristjansdottir, Berglind S Haraldsson, Gunnsteinn Baldursson, Olafur Kristinsson, Karl G Gottfredsson, Magnus |
author_sort |
Bjarnason, Agnar |
title |
Severity of influenza A 2009 (H1N1) pneumonia is underestimated by routine prediction rules. Results from a prospective, population-based study. |
title_short |
Severity of influenza A 2009 (H1N1) pneumonia is underestimated by routine prediction rules. Results from a prospective, population-based study. |
title_full |
Severity of influenza A 2009 (H1N1) pneumonia is underestimated by routine prediction rules. Results from a prospective, population-based study. |
title_fullStr |
Severity of influenza A 2009 (H1N1) pneumonia is underestimated by routine prediction rules. Results from a prospective, population-based study. |
title_full_unstemmed |
Severity of influenza A 2009 (H1N1) pneumonia is underestimated by routine prediction rules. Results from a prospective, population-based study. |
title_sort |
severity of influenza a 2009 (h1n1) pneumonia is underestimated by routine prediction rules. results from a prospective, population-based study. |
publishDate |
2013 |
url |
http://hdl.handle.net/2336/295220 https://doi.org/10.1371/journal.pone.0046816 |
long_lat |
ENVELOPE(-63.000,-63.000,-64.300,-64.300) |
geographic |
Psi |
geographic_facet |
Psi |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3469650/ PLoS ONE 2012, 7(10):e46816 1932-6203 23071646 doi:10.1371/journal.pone.0046816 http://hdl.handle.net/2336/295220 PloS one |
op_rights |
Archived with thanks to PloS one Open Access - Opinn aðgangur |
op_doi |
https://doi.org/10.1371/journal.pone.0046816 |
container_title |
PLoS ONE |
container_volume |
7 |
container_issue |
10 |
container_start_page |
e46816 |
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1766039810481324032 |