Severe virus associated community acquired pneumonia: predictors of lethality

Authors

  • T. O. Pertseva Dnіpropetrovsk State Medical Academy,
  • T. V. Kireyeva Dnіpropetrovsk State Medical Academy,
  • K. O. Bielosludtseva Dnіpropetrovsk State Medical Academy,
  • S. V. Boltyanskiy Dnipropetrovsk clinical association of ambulance,
  • O. P. Nazarenko Dnipropetrovsk Hospital №16,

DOI:

https://doi.org/10.14739/2310-1210.2016.3.76924

Keywords:

Pneumonia, Mortality, Influenza Viruses

Abstract

Despite the fact that the influenza virus pathogenicity factors have been well studied in vitro, in vivo lack is presented in understanding of the those risk factors, objective and laboratory parameters, which related most of all to the fatal virus-associated community-aquired pneumonia (CAP).

That is why the purpose of the study was to study the clinical and laboratory characteristics of patients with severe virus-associated CAP during the 2015–2016 influenza epidemic and their role as predictors of patients’ mortality.

To do this, patients with severe virus-associated CAP were examined. They were divided into 2 groups depending on the outcome of treatment: 1st- deaths from the virus-associated severe CAP and 2nd - patients with successful treatment of the severe virus-associated CAP. Special statistical method was used – one-dimensional analysis of variance to compare individual parameters between the two groups of patients (surviving and deceased). Pearson χ2 test (contingency table) was used for categorical variables. Factors that were significant predictors of mortality as a result of univariate analysis were tested using multifactorial analysis using logistic regression. In the final model, each parameter must have had a significant impact on mortality.

It was found that risk factors for death in patients with severe virus-associated CAP according to univariate analysis were: presence of obesity, disorders of consciousness, BH≥35 min, SaO2<80%, PaO2<50 mm Hg, mmHg PaCO2 ≥50 mmHg during hospitalization. Independent predictors of mortality according to the logistic regression are the presence of obesity, disorders of consciousness, PaO2<50 mm Hg, mmHg PaCO2 ≥50 mmHg. Given that among clinical and laboratory parameters key parameters that significantly influence the outcome, are indicators of the severity of hypoxia and hypoxemia, a major step in determining the severity of the patients with virus-associated severe emergency is diagnostics of blood gas composition, and during treatment – early sufficient and adequate oxygen therapy with regular monitoring of its effectiveness and timely correction.

References

Informatsiinyi biuleten Tsentru hrypu ta HRVI Derzhavnoho zakladu «Ukrainskyi tsentr z kontroliu ta monitorynhu zakhvoriuvan MOZ Ukrainy» [Newsletter of the Center for influenza and ARI State institution «Ukrainian Centre for Disease Control and monitoring of the Ministry of Health of Ukraine»] Retrieved from http://www.dsesu.gov.ua/ua/dses-ua/novyny/item/1938-zakhvoriuvanist-na-hryp-ta-hrvi-zrosla-na-mynulomu-tyzhni. [in Ukrainian].

Kiselev, O. I., Tsyibalova, L. M., Pokrovskij, V. I. (2012) Gripp. Epidemiologiya, diagnostika, lechenie [Influenza. Еpidemiology, diagnostics, treatment, prophylaxis]. Moscow: Medicinskoe informacionnoe agentstvo. [in Russian].

Lapach, S. N., Gubenko, A. V., & Babich, P. N. (2000). Statisticheskie metody v mediko-biologicheskikh issledovaniyakh s ispol'zovaniem Exel [Statistical methods in biomedical research using Exel]. Kyiv: Morion [in Ukrainian].

Nakaz MOZ Ukrainy Pro zatverdzhennia klinichnykh protokoliv nadannia medychnoi dopomohy za spetsialnistiu «Pulmonolohiia» vid 19.03.2007 r. №128 [Order of Ukraine On approval of clinical protocols of care in the specialty "Pulmonology": №128 from 19.03.2007]. Kyiv. [in Ukrainian].

Rebrova, O. Yu. (2002) Statisticheskij analiz medicinskikh dannykh. Primenenie paketa prikladnykh programm STATISTICA [Statistical analysis of medical data. Application packages of STATISTICA]. Moscow: MediaSfera [in Russian].

Arias, C. F., Escalera-Zamudio, M., Soto-del Rio, M., Cobián-Güemes, A. G., Isa, P., & López, S. (2009). Molecular anatomy of 2009 influenza virus A(H1N1). Archives of Medical Research, 40, 643–654. doi: 10.1016/j.arcmed.2009.10.007.

Garten, R. J., Davis, C. T., Russell, C. A., Shu, B., Lindstrom, S., Balish, A., et al. (2009). Antigenic and henetic characteristics of swine-origin 2009 A(H1N1) influenza viruses circulating in humans. Science. – 325 (5937), 197–201. doi: 10.1126/science.1176225.

Karlas, A., Machuy, N., Shin, Y., Pleissner, K. P., Artarini, A., Heuer, D., et al. (2010). Genome-wide RNAi screen indentifies human host actors crucial for influenza virus replication. Nature, 463, 818–822. doi: 10.1038/nature08760.

Mira, J-P., Max, A., & Burgel, P-R. (2008) The role of biomarkers in community-acquired pneumonia: predicting mortality and response to adjunctive therapy. Critical Care, 12, 1–7. doi: 10.1186/cc7028

Сhrist-Crain, M., Stolz, D., Bingisser, R., Müller, C., Miedinger, D., Huber, P.R., et al. (2006) Procalcitonin guidance of antibiotic therapy in community-acquired pneumonia. American Review of Respiratory Disease., 174, 84–93.

Downloads

How to Cite

1.
Pertseva TO, Kireyeva TV, Bielosludtseva KO, Boltyanskiy SV, Nazarenko OP. Severe virus associated community acquired pneumonia: predictors of lethality. Zaporozhye Medical Journal [Internet]. 2016Sep.6 [cited 2024Nov.13];18(3). Available from: http://zmj.zsmu.edu.ua/article/view/76924

Issue

No. 3 (2016): Zaporozhye medical journal

Section

Original research

License

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.  Лицензия Creative Commons
    2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
    3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)