• J. Korean Med. Sci. · Apr 2011

    A prediction rule to identify severe cases among adult patients hospitalized with pandemic influenza A (H1N1) 2009.

    • Won Sup Oh, Seung-Joon Lee, Chang-Seop Lee, Ji-An Hur, Ae-Chung Hur, Yoon Seon Park, Sang-Taek Heo, In-Gyu Bae, Sang Won Park, Eu Suk Kim, Hong Bin Kim, Kyoung-Ho Song, Kkot Sil Lee, Sang-Rok Lee, Joon Sup Yeom, Su Jin Lee, Baek-Nam Kim, Yee Gyung Kwak, Jae Hoon Lee, Yong Keun Kim, Hyo Youl Kim, Nam Joong Kim, and Myoung-Don Oh.
    • Department of Internal Medicine, Kangwon National University School of Medicine, Chucheon, Korea.
    • J. Korean Med. Sci. 2011 Apr 1; 26 (4): 499506499-506.

    AbstractThe purpose of this study was to establish a prediction rule for severe illness in adult patients hospitalized with pandemic influenza A (H1N1) 2009. At the time of initial presentation, the baseline characteristics of those with severe illness (i.e., admission to intensive care unit, mechanical ventilation, or death) were compared to those of patients with non-severe illnesses. A total of 709 adults hospitalized with pandemic influenza A (H1N1) 2009 were included: 75 severe and 634 non-severe cases. The multivariate analysis demonstrated that altered mental status, hypoxia (PaO(2)/FiO(2) ≤ 250), bilateral lung infiltration, and old age (≥ 65 yr) were independent risk factors for severe cases (all P < 0.001). The area under the ROC curve (0.834 [95% CI, 0.778-0.890]) of the number of risk factors were not significantly different with that of APACHE II score (0.840 [95% CI, 0.790-0.891]) (P = 0.496). The presence of ≥ 2 risk factors had a higher sensitivity, specificity, positive predictive value and negative predictive value than an APACHE II score of ≥ 13. As a prediction rule, the presence of ≥ 2 these risk factors is a powerful and easy-to-use predictor of the severity in adult patients hospitalized with pandemic influenza A (H1N1) 2009.

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