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Multicenter Study
. 2012 Jul;67(7):1739-45.
doi: 10.1093/jac/dks098. Epub 2012 Mar 30.

Prognosis of hospitalized patients with 2009 H1N1 influenza in Spain: influence of neuraminidase inhibitors

Miguel Delgado-Rodríguez  1 , Jesús Castilla, Pere Godoy, Vicente Martín, Nuria Soldevila, Jordi Alonso, Jenaro Astray, Maretva Baricot, Rafael Cantón, Ady Castro, Fernando Gónzález-Candelas, José María Mayoral, José María Quintana, Tomás Pumarola, Sonia Tamames, Marc Sáez, Angela Domínguez; CIBERESP Cases and Controls in Pandemic Influenza Working Group
Collaborators, Affiliations
Multicenter Study

Prognosis of hospitalized patients with 2009 H1N1 influenza in Spain: influence of neuraminidase inhibitors

Miguel Delgado-Rodríguez et al. J Antimicrob Chemother. 2012 Jul.

Abstract

Background: The H1N1 influenza pandemic strain has been associated with a poor prognosis in hospitalized patients. The present report evaluates the factors influencing prognosis.

Methods: A total of 813 patients hospitalized with H1N1 influenza in 36 hospitals (nationwide) in Spain were analysed. Detailed histories of variables preceding hospital admission were obtained by interview, validating data on medications and vaccine with their attending physicians. Data on treatment and complications during hospital stay were recorded. As definition of poor outcome, the endpoints of death and admission to intensive care were combined; and as a further outcome, length of stay was used.

Results: The mean age was 38.5 years (SD 22.8 years). There were 10 deaths and 79 admissions to intensive care (combined, 88). The use of neuraminidase inhibitors was reported by 495 patients (60.9%). The variables significantly associated with a poor outcome were diabetes (OR = 2.21, 95% CI = 1.21-4.02), corticosteroid therapy (OR = 3.37, 95% CI = 1.39-8.20) and use of histamine-2 receptor antagonists (OR = 2.68, 95% CI = 1.14-6.36), while the use of neuraminidase inhibitors (OR = 0.57, 95% CI = 0.34-0.94) was protective. Neuraminidase inhibitors within the first 2 days after the influenza onset reduced hospital stay by a mean of 1.9 days (95% CI = 4.7-6.6).

Conclusions: The use of neuraminidase inhibitors decreases the length of hospital stay and admission to intensive care and/or death.

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References

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