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. 2019 Oct 29;6(11):ofz462.
doi: 10.1093/ofid/ofz462. eCollection 2019 Nov.

Determinants of Fatal Outcome in Patients Admitted to Intensive Care Units With Influenza, European Union 2009-2017

Cornelia Adlhoch  1 , Joana Gomes Dias  1 , Isabelle Bonmarin  2 , Bruno Hubert  2 , Amparo Larrauri  3 , Jesús A Oliva Domínguez  3 , Concepción Delgado-Sanz  3 , Mia Brytting  4 , Annasara Carnahan  4 , Odette Popovici  5 , Emilia Lupulescu  5 , Joan O'Donnell  6 , Lisa Domegan  6 , Arianne B Van Gageldonk-Lafeber  7 , Adam Meijer  7 , Jan Kynčl  8 , Pavel Slezák  8 , Raquel Guiomar  9 , Carlos M Orta Gomes  10 , Theresia Popow-Kraupp  11 , Ján Mikas  12 , Edita Staroňová  12 , Jackie M Melillo  13 , Tanya Melillo  13 , Niina Ikonen  14 , Outi Lyytikäinen  14 , René Snacken  1 , Pasi Penttinen  15
Affiliations

Determinants of Fatal Outcome in Patients Admitted to Intensive Care Units With Influenza, European Union 2009-2017

Cornelia Adlhoch et al. Open Forum Infect Dis. .

Abstract

Background: Morbidity, severity, and mortality associated with annual influenza epidemics are of public health concern. We analyzed surveillance data on hospitalized laboratory-confirmed influenza cases admitted to intensive care units to identify common determinants for fatal outcome and inform and target public health prevention strategies, including risk communication.

Methods: We performed a descriptive analysis and used Poisson regression models with robust variance to estimate the association of age, sex, virus (sub)type, and underlying medical condition with fatal outcome using European Union data from 2009 to 2017.

Results: Of 13 368 cases included in the basic dataset, 2806 (21%) were fatal. Age ≥40 years and infection with influenza A virus were associated with fatal outcome. Of 5886 cases with known underlying medical conditions and virus A subtype included in a more detailed analysis, 1349 (23%) were fatal. Influenza virus A(H1N1)pdm09 or A(H3N2) infection, age ≥60 years, cancer, human immunodeficiency virus infection and/or other immune deficiency, and heart, kidney, and liver disease were associated with fatal outcome; the risk of death was lower for patients with chronic lung disease and for pregnant women.

Conclusions: This study re-emphasises the importance of preventing influenza in the elderly and tailoring strategies to risk groups with underlying medical conditions.

Keywords: EU; age; influenza virus; intensive care units; underlying medical conditions.

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Figures

Figure 1.
Figure 1.
Flow chart of cases included in the analysis. ICU, intensive care unit.
See this image and copyright information in PMC

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