• Matthaios Papadimitriou-Olivgeris, Nikitas Gkikopoulos, Melissa Wüst, Aurelie Ballif, Valentin Simonin, Marie Maulini, Charly Nusbaumer, Bertaiola Monnerat Luce L Laboratory Department, Hospital of Jura, Delémont, Switzerland., Jonathan Tschopp, Eleftheria-Evdokia Kampouri, Patrick Wilson, and Hervé Duplain.
• Department of Internal Medicine, Hospital of Jura, Delémont, Switzerland; Department of Infectious Diseases, University Hospital of Lausanne, Lausanne, Switzerland. Electronic address: Matthaios.Papadimitriou-Olivgeris@chuv.ch.
• Eur. J. Intern. Med. 2020 Apr 1; 74: 86-91.

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.Copyright © 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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