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Year : 2012  |  Volume : 2  |  Issue : 2  |  Page : 34-37

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

1 Emergency Services, Al-Mouassat University Hospital, Damascus, Syria
2 Pulmonary Department, Ibn Alnafees Hospital, Damscus, Syria
3 Critical Care Medicine Department, Damascus Hospital, Damascus, Syria
4 Pulmonary Department, Assad University Hospital, Damascus, Syria
5 Word Health Organization, Damascus, Syria
6 Adult Critical Care Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

Correspondence Address:
Mazen Kherallah
King Faisal Specialist Hospital and Research Center, P. O. Box 3354, MBC #94, Riyadh, 11211
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2231-0770.99156

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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.

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