单一癌症中心血液学/肿瘤学患者流感感染的临床表现和结果:大流行和大流行后季节

Mustafa Saad, Wail Hayajneh, Sawsan Mubarak, Ibraheem Yousef, Hazem Awad, Wafa Elbjeirami, Rawad Rihani
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引用次数: 10

摘要

背景:流感可引起血液学/肿瘤学患者严重感染。2009年大流行的发生为研究流感在大流行季节和大流行后季节对这类患者的影响提供了机会。方法:回顾性分析2009年流感大流行期间和流感大流行后第一个季节实验室确诊的血液学/肿瘤学患者的医疗记录。我们评估了两个季节的流感相关结果,重点是肺炎的发展和死亡率。我们还分析了与不良结果相关的因素。结果:我们纳入了350例患者;207例在大流行期间确诊,143例在大流行后季节确诊。两个季节的流感严重程度相似,在肺炎的发展或死亡方面没有显著差异。感染pH1N1病毒与肺炎的发生相关(24.7% vs 14.9%, p = 0.029),但不影响死亡率。多因素分析显示,在> 48 h后开始抗病毒治疗、卫生保健获得流感和低白蛋白是肺炎发展的独立危险因素(p值分别为0.022、0.003和< 0.0001)。对数秩检验显示,在症状出现后> 48小时接受治疗的患者死亡率增加(p = 0.001)。结论:在血液学/肿瘤学患者中,流感在大流行后与大流行季节一样严重。肺炎在感染h1n1病毒的患者中更为常见。感染和低白蛋白与肺炎的发生有关。延迟开始抗病毒治疗与肺炎和死亡率都有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical presentations and outcomes of influenza infection among hematology/oncology patients from a single cancer center: pandemic and post-pandemic seasons.

Background: Influenza can cause severe infection in hematology/oncology patients. The occurrence of the 2009 pandemic represented an opportunity to study the impact of influenza on such patients in pandemic and post-pandemic seasons.

Methods: We retrospectively reviewed medical records of hematology/oncology patients who had laboratory-confirmed influenza infection during the 2009 pandemic and the first post-pandemic seasons. We assessed influenza-related outcomes in both seasons with emphasis on the development of pneumonia and mortality. We also analyzed factors associated with poor outcomes.

Results: We included 350 patients; 207 were diagnosed in the pandemic and 143 in the post-pandemic seasons. Influenza severity was similar in both seasons with no significant differences in the development of pneumonia or death. Infection with the pH1N1 virus was associated with the development of pneumonia (24.7% vs 14.9%, p = 0.029) but did not affect mortality. A multivariate analysis showed that initiation of antiviral treatment after > 48 h, healthcare acquisition of influenza, and low albumin were independent risk factors for the development of pneumonia (p values 0.022, 0.003, and < 0.0001, respectively). A log-rank test showed increased mortality in patients who received therapy > 48 h after onset of symptoms (p = 0.001).

Conclusions: In hematology/oncology patients, influenza was as severe in the post-pandemic as in the pandemic season. Pneumonia developed more commonly in patients infected with pH1N1 virus. Healthcare acquisition of infection and low albumin were associated with the development of pneumonia. Delayed initiation of antiviral treatment was associated with both pneumonia and mortality.

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