Critically Ill Patients with Pandemic Influenza A/H1N1 2009 at a Medical Center in Korea.

Choi, Eun Young; Huh, Jin Won; Lim, Chae Man; Koh, Younsuck; Kim, Sung Han; Choi, Sang Ho; Kim, Won Young; Kim, Won; Kim, Mi Na; Hong, Sang Bum

doi:2011.70.1.28

Tuberc Respir Dis > Volume 70(1); 2011 > Article

Original Article

Tuberculosis and Respiratory Diseases 2011;70(1):28-35.
DOI: https://doi.org/10.4046/trd.2011.70.1.28 Published online January 1, 2011.

Critically Ill Patients with Pandemic Influenza A/H1N1 2009 at a Medical Center in Korea.

Eun Young Choi, Jin Won Huh, Chae Man Lim, Younsuck Koh, Sung Han Kim, Sang Ho Choi, Won Young Kim, Won Kim, Mi Na Kim, Sang Bum Hong

¹Department of Respiratory and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. sbhong@amc.seoul.kr
²Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
³Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
⁴Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
The aim of the study was to describe the characteristics, treatments, and outcomes of critically ill patients with pandemic Influenza A/H1N1 2009 at a major medical center in Korea. METHODS: This retrospective observational study examined critically ill adult patients with pandemic Influenza A/H1N1 2009, who were admitted to the AMC between August and December 2009. RESULTS: 27 patients with confirmed pandemic Influenza A/H1N1 2009 were admitted to the intensive care unit (ICU) at the Asan Medical Center (AMC). The median age (IQR) was 59 years (41~67), and 66.7% of the patients were older than 51 years. A total of 81.5% of the patients had 2 or more co-morbidities. The median time (IQR) from symptom onset to presentation was 2 days (1~4), and the median time from presentation to ICU admission was 0 days (0~1.5). All patients received oseltamivir (300 mg/day) and 13 patients received triple combination therapy (oseltamivir, amantadine, ribavirin). Twelve patients required mechanical ventilation on the first day of ICU admission. A total of 6 patients (22.2%) died within 28 days of admission. The patients who died had significantly higher acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores at presentation. There were no significant differences in age, co-morbidities, or antiviral regimens between survivors and non-survivors. CONCLUSION: Critical illness related to pandemic Influenza A/H1N1 2009 was common in elderly patients with chronic co-morbidities. All patients were given high-dose oseltamivir or triple combination antiviral therapy. Nonetheless, patients with critical illnesses associated with pandemic Influenza A/H1N1 2009 had a death rate of 22.2%.

Key Words: Influenza A Virus, H1N1 Subtype, Pandemics, Critical Illness, Mortality