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CC BY-NC-ND 4.0 · Avicenna J Med 2012; 02(02): 34-37
DOI: 10.4103/2231-0770.99156
ORIGINAL ARTICLE

Characteristics and outcome of critically ill patients with 2009 H1N1 influenza infection in Syria

Reem Alsadat
Emergency Services, Al-Mouassat University Hospital, Damascus, Syria
,
Abdulrahman Dakak
Pulmonary Department, Ibn Alnafees Hospital, Damscus,Syria
,
Mouna Mazlooms
Critical Care Medicine Department, Damascus Hospital, Damascus, Syria
,
Ghasan Ghadhban
Pulmonary Department, Assad University Hospital, Damascus, Syria
,
Shadi Fattoom
Pulmonary Department, Assad University Hospital, Damascus, Syria
,
Ibrahim Betelmal
Word Health Organization, Damascus, Syria
,
Nabil Abouchala
Adult Critical Care Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
,
Mazen Kherallah
Adult Critical Care Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Abstract

Objectives: To describe the epidemiologic characteristics, clinical features, and outcome of severe cases of 2009 H1N1 influenza A infections who were admitted to the intensive care units (ICUs) in Damascus, Syria. Materials and Methods: Retrospectively, we collected clinical data on all patients who were admitted to the ICU with confirmed or suspected diagnosis of severe 2009 H1N1 influenza A with respiratory failure at 4 major tertiary care hospitals in Damascus, Syria. Acute Physiology and Chronic Health Evaluation (APACHE) II system was used to assess the severity of illness within the first 24 h after admission. The outcome was overall hospital mortality. Results: Eighty patients were admitted to the ICU with severe 2009 H1N1 infection. The mean age was 40.7 years; 69.8% of patients had ≥1 of the risk factors: asthmatics 20%, obesity 23.8%, and pregnancy 5%; and 72.5% had acute lung injury or adult respiratory distress syndrome, 12.5% had viral pneumonia, 42.5% had secondary bacterial pneumonia, and 15% had exacerbation of airflow disease. Mechanical ventilation was required in 73.7% of cases. The mean hospital length of stay was 11.7 days (median 8 days, range 0-77 days, IQR: 5-14 days). The overall mortality rate was 51% for a mean APACHE II score of 15.2 with a predicted mortality of 21% (standardized mortality ratio of 2.4, 95% confidence interval: 1.7-3.2, P value < 0.001). Conclusion: Critically ill patients with severe 2009 H1N1 infection in this limited resource country had a much higher mortality rate than the predicted APACHE II mortality rate or when compared with the reported mortality rates for severe cases in other countries during 2009 H1N1 pandemic.

Keywords

Adult respiratory distress syndrome - H1N1 - pandemic - Syria


Publication History

Article published online:
09 August 2021

© 2012. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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