Associations Between Severe Influenza-Complicated Thromboembolism Events, Intensive Care Unit Stays and Mortality, and Associated Risk Factors: A Retrospective Cohort Study

IF 4.3 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses Pub Date : 2024-08-27 DOI:10.1111/irv.13354

Wei-Chun Lee, Che-Chia Chang, Meng-Chin Ho, Chin-Kuo Lin, Chieh-Mo Lin, Yu-Hung Fang, Shu-Yi Huang, Yu-Ching Lin, Min-Chun Chuang, Tsung-Ming Yang, Ming-Szu Hung, Yen-Li Chou, Ying-Huang Tsai, Meng-Jer Hsieh

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Abstract

The association between influenza infection and thromboembolism (TE) events, including cardiovascular events, cerebrovascular events, pulmonary embolism, and deep vein thrombosis, is supported by compelling evidence. However, there is a disparity in the risk factors that impact the outcomes of severe influenza-complicated TE in intensive care unit (ICU) patients. The objective of this study was to evaluate the outcomes of severe influenza-complicated TE in ICU patients and identify any associated risk factors.

Methods

A retrospective cohort study was conducted, recruiting consecutive patients with TE events admitted to the ICU between December 2015 through December 2018 at our institution in Taiwan. The study included a group of 108 patients with severe influenza and a control group of 192 patients with severe community-acquired pneumonia. Associations between complicated TE, length of ICU stay, and 90-day mortality were evaluated using logistic regression analysis, and risk factors were identified using univariate and multivariate generalized linear regression analyses.

Results

TE event prevalence was significantly higher in ICU patients with severe influenza than in ICU patients with severe CAP (21.3% vs. 5.7%, respectively; p < 0.05). Patients with severe influenza who developed TE experienced a significant increase in the ratio of mechanical ventilation use, length of mechanical ventilation use, ICU stay, and 90-day mortality when compared to patients without TE (all p < 0.05). The comparison of severe CAP patients with and without TE revealed no significant differences (p > 0.05). The development of thromboembolic events in patients with severe influenza or severe noninfluenza CAP is linked to influenza infection and hypertension (p < 0.05). Furthermore, complicated TE and the severity of the APACHE II score are risk factors for 90-day mortality in ICU patients with severe influenza (p < 0.05).

Conclusions

Patients with severe influenza and complicated TE are more likely to have an extended ICU stay and 90-day mortality than patients with severe CAP. The risk is significantly higher for patients with a higher APACHE II score. The results of this study may aid in defining better strategies for early recognition and prevention of severe influenza-complicated TE.

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重症流感并发血栓栓塞事件、重症监护病房住院时间和死亡率与相关风险因素之间的关系：一项回顾性队列研究。

有确凿证据表明，流感感染与血栓栓塞（TE）事件（包括心血管事件、脑血管事件、肺栓塞和深静脉血栓形成）之间存在关联。然而，影响重症监护病房（ICU）患者重症流感并发 TE 后果的风险因素却不尽相同。本研究旨在评估重症监护病房患者重症流感并发TE的预后，并确定相关的风险因素：我们开展了一项回顾性队列研究，招募了2015年12月至2018年12月期间在台湾本院重症监护病房连续入院的TE事件患者。研究对象包括108名重症流感患者和192名重症社区获得性肺炎患者。使用逻辑回归分析评估了复杂TE、ICU住院时间和90天死亡率之间的关联，并使用单变量和多变量广义线性回归分析确定了风险因素：结果：重症流感重症监护病房患者的TE事件发生率明显高于重症CAP重症监护病房患者（分别为21.3%和5.7%；P 0.05）。重症流感或重症非流感 CAP 患者血栓栓塞事件的发生与流感感染和高血压有关（P 结论：重症流感和复杂的 TE 患者的血栓栓塞事件发生率明显高于重症 CAP 患者（分别为 21.3% 和 5.7%；P 0.05）：与重症 CAP 患者相比，重症流感和复杂 TE 患者更有可能延长重症监护病房的住院时间和 90 天死亡率。APACHE II 评分较高的患者风险明显更高。这项研究的结果有助于制定更好的策略，以早期识别和预防重症流感并发 TE。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Influenza and Other Respiratory Viruses 医学-病毒学

CiteScore

7.20

自引率

4.50%

发文量

120

审稿时长

6-12 weeks

期刊介绍： Influenza and Other Respiratory Viruses is the official journal of the International Society of Influenza and Other Respiratory Virus Diseases - an independent scientific professional society - dedicated to promoting the prevention, detection, treatment, and control of influenza and other respiratory virus diseases. Influenza and Other Respiratory Viruses is an Open Access journal. Copyright on any research article published by Influenza and Other Respiratory Viruses is retained by the author(s). Authors grant Wiley a license to publish the article and identify itself as the original publisher. Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors, citation details and publisher are identified.