Highlights
- •441 influenza virus infections from a Swiss Hospital were included.
- •During 4 influenza seasons, 238 infections due to influenza A virus; 203 due to b.
- •30-day mortality was 6.0% and independently associated with A virus.
- •qSOFA≥2 points showed a very good accuracy (0.89).
- •Hospital-acquired infection was a predictor of worst outcome.
Abstract
Background
Influenza 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.
Methods
All 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.
Results
Among 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).
Conclusion
qSOFA 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.
Keywords
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Article info
Publication history
Published online: December 31, 2019
Accepted:
December 24,
2019
Received in revised form:
December 18,
2019
Received:
September 19,
2019
Identification
Copyright
© 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
