Source: Annual Congress 2011 - The new clinical spectrum of lung diseases: from bronchi to pleura
Disease area: Respiratory infections

Abstract

Severe flu associated respiratory infections remain actual.
Aim: to evaluate the prognostic model of outcome of severe viral-bacterial community acquired pneumonia (VBCAP) during flu H1N1 pandemia based on hospital admission data.
Materials: 84 patients (43 survivors and 41 non-survivors) admitted with VBCAP in hospitals of Bashkortostan region between November and December 2009 were included in the retrospective study. The endpoint was defined as hospital mortality.
Methods and results. Initially 16 demography, history, functional and laboratory variables were obtained from hospital admission records. In the univariate ROC analysis, 5 variables were correlated with poor outcome of VBCAP.

Univariate ROC-analysis results

Cut-off point	Sensitivity	Specifity	Area under ROC-curve (95%CI)
SpO2<90%	72.7	93.9	0,89 (0,78-0,96)
Breathing rate>20 /min.	86,4	66.7	0,84(0,71-0,92)
Serum glucose >5 mmol/l	77,3	63,6	0,69 (0,55-0,81)
Age<40 years	68,2	69,7	0,68(0,54-0,70)
WBC<6,9 *10^9/l	50,0	84,8	0,68(0,54-0,80)

Cutoffs were used to transfer continuous variables to dichotomous ones. Multivariate stepwise logistic regression analysis identified SpO2% and white blood cell count as independent predictive factors at p<0.05.
Logistic regression equation:
logit P= 3,49×"SpO2<90%"+2,24×"WBC<6,9*10^9/l"-1,76, where P- poor outcome probability. Correct classification rate was 82,8%.
Conclusion: acute respiratory failure and diminished immune response are the most powerful independent prognostic factors of poor outcome of viral-bacterial pneumonia during flu H1N1 pandemia.

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Citations should be made in the following way:
R. Zulkarneev, S. Zagidullin, M. Sadritdinov, U. Farhutdinov, V. Leshkova, N. Vlasova, V. Mustafina (Ufa, Russian Federation). Arterial hypoxemia and diminished immune response at admission predict poor outcome in patients with viral-bacterial pneumonia during flu H1N1 pandemic period. Eur Respir J 2011; 38: Suppl. 55, 496

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