Chest
Original ResearchInfluenza A(H1N1) InfectionClinical Findings and Demographic Factors Associated With ICU Admission in Utah Due to Novel 2009 Influenza A(H1N1) Infection
Section snippets
Materials and Methods
Individuals with confirmed novel A(H1N1) who were older than 15 years and treated in four ICUs at three academic hospitals in Salt Lake County, Utah, from May 19, 2009, to June 30, 2009, were included in this report. We identified patients concurrently and reviewed medical charts, radiologic and laboratory findings, hospital billing charges, length of stay, and in-hospital survival. The report was declared exempt by the institutional review boards of Intermountain Healthcare and the University
Clinical Data
Forty-seven patients with novel A(H1N1) infection were admitted to one of four adult ICUs among three academic hospitals between May 19, 2009, and June 30, 2009. The median age of patients was 34 years (range 15-62 years) (Table 1). Twenty (43%) were men. Most had typical influenza symptoms on illness presentation, including fever (100%), cough (89%), and shortness of breath (66%). Sixty-two percent had one or more risk factors for influenza-related complications as defined by the CDC.15 The
Discussion
This case series reveals the spectrum of critical illness among a young cohort with severe ARDS and multiorgan dysfunction solely attributable to novel A(H1N1) infection seen during a 6-week period in Salt Lake County. We also report demographic features in our ICU cohort (race/ethnicity, BMI, and medical insurance) compared with the Salt Lake County population.
Severe infection from influenza typically occurs in the elderly, the very young, and those with comorbid diseases.19 Consistent with
Conclusions
We report a critically ill cohort with unexpected numbers of nonwhite, obese, medically uninsured patients with novel A(H1N1) infection, most with severe lung injury and multiorgan dysfunction due to influenza without concomitant bacterial infection. Our findings suggest that demographic factors and obesity are associated with critical illness due to novel A(H1N1) infection.
Acknowledgments
Author contributions: Dr Miller: contributed to collecting data and drafting and revising the submitted manuscript.
Dr Markewitz: contributed to collecting data and drafting and revising the submitted manuscript.
Dr Rolfs: contributed to collecting data and drafting and revising the submitted manuscript.
Dr Brown: contributed to drafting and revising the submitted manuscript.
Dr Dascomb: contributed to drafting and revising the submitted manuscript.
Dr Grissom: contributed to drafting and revising
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