Predictors of mortality of influenza virus infections in a Swiss Hospital during four influenza seasons: Role of quick sequential organ failure assessment |
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| Affiliation: | 1. Department of Internal Medicine, Hospital of Jura, Delémont, Switzerland;2. Department of Infectious Diseases, University Hospital of Lausanne, Lausanne, Switzerland;3. Laboratory Department, Hospital of Jura, Delémont, Switzerland;4. Faculty of biology and medicine, University of Lausanne, Lausanne, Switzerland;1. University of Eastern Piedmont, Novara, Italy;2. Campus Bio-Medico Hospital, Rome;3. San Filippo Neri Hospital of Rome, Italy;1. Clinical Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy;2. Vita-Salute San Raffaele University, Milan, Italy;1. Center of Research of Immunopathology and Rare Diseases, Coordinating Center of Piemonte and Valle d''Aosta Network for Rare Diseases, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, University of Turin, Italy;2. School of Specialization of Clinical Pathology, Department of Clinical and Biological Sciences, University of Turin, Italy;3. Nephrology and Dialysis, Department of Clinical and Biological Sciences, S. Giovanni Bosco Hospital, University of Turin, Italy;4. AOU Città della Salute e della Scienza, Turin, Italy;1. Section of Internal and Cardiopulmonary Medicine, Department of Medical Science, Faculty of Medicine, University of Ferrara, Ferrara, Italy;2. Department of Cardiology, Santa Maria della Misericordia Hospital, Rovigo, Italy |
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| Abstract: | BackgroundInfluenza infections have been associated with high morbidity. The aims were to determine predictors of mortality among patients with influenza infections and to ascertain the role of quick Sequential Organ Failure Assessment (qSOFA) in predicting poor outcomes.MethodsAll adult patients with influenza infection at the Hospital of Jura, Switzerland during four influenza seasons (2014/15 to 2017/18) were included. Cepheid Xpert Xpress Flu/RSV was used during the first three influenza seasons and Cobas Influenza A/B and RSV during the 2017/18 season.ResultsAmong 1684 influenza virus tests performed, 441 patients with influenza infections were included (238 for influenza A virus and 203 for B). The majority of infections were community onset (369; 83.7%). Thirty-day mortality was 6.0% (25 patients). Multivariate analysis revealed that infection due to A virus (P 0.035; OR 7.1; 95% CI 1.1–43.8), malnutrition (P < 0.001; OR 25.0; 95% CI 4.5–138.8), hospital-acquired infection (P 0.003; OR 12.2; 95% CI 2.3–65.1), respiratory insufficiency (PaO2/FiO2 < 300) (P < 0.001; OR 125.8; 95% CI 9.6–1648.7) and pulmonary infiltrate on X-ray (P 0.020; OR 6.0; 95% CI 1.3–27.0) were identified as predictors of mortality. qSOFA showed a very good accuracy (0.89) equivalent to other more specific and burdensome scores such as CURB-65 and Pneumonia Severity Index (PSI).ConclusionqSOFA performed similarly to specific severity scores (PSI, CURB-65) in predicting mortality. Infection by influenza A virus, respiratory insufficiency and malnutrition were associated with worse prognosis. |
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