First influenza season after the 2009 pandemic influenza: report of the first 300 ICU admissions in Spain
Primera epidemia de gripe estacional después de la pandemia por gripe A en 2009: descripción de los primeros 300 ingresos en UCI espa¿nolas
A. Rodrígueza,
, I. Martin-Loechesa, J. Bonastreb, P. Olaecheac, F. Álvarez-Lermad, R. Zaragozae, J. Guerrerof, J. Blancog, F. Gordoh, F. Pozoi, J. Lorentej, J. Carratalák, M. Corderol, J. Rellom, A. Estebani, C. Leónn, SEMICYUC-CIBERES-REIPI working group *
Corresponding author
a Hospital Joan XXIII, Critical Care Department, IISPV, URV, CIBER Enfermedades Respiratorias, Tarragona, Spain
b Hospital La Fe, Critical Care Department, CIBER Enfermedades Respiratorias, Valencia, Spain
c Hospital Galdakao-Usansolo, Critical Care Department, CIBER Enfermedades Respiratorias, Vizcaya, Spain
d Hospital del Mar, Critical Care Department, CIBER Enfermedades Respiratorias, Barcelona, Spain
e Hospital Dr. Peset, Critical Care Department, Valencia, Spain
f Hospital Gregorio Mara¿nón, Critical Care Department, CIBER Enfermedades Respiratorias, Madrid, Spain
g Hospital Rio Hortega, Critical Care Department, CIBER Enfermedades Respiratorias, Valladolid, Spain
h Hospital del Henares, Critical Care Department, Madrid, Spain
i Pulmonology Department, Hospital 12 de Octubre, Madrid, Spain
j Hospital de Getafe, Critical Care Department, CIBER Enfermedades Respiratorias, Madird, Spain
k Hospital de Bellvitge, Infectious Disease Department, REIPI, L’Hospitalet de Llobregat, Barcelona, Spain
l Hospital Virgen del Rocío, Infectious Disease Department, REIPI, Sevilla, Spain
m Hospital Vall d’Hebron, Critical Care Department, IRVH, CIBER Enfermedades Respiratorias, Barcelona, Spain
n Critical Care Department, Hospital Universitario de Valme, Sevilla, Spain
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class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Hospital del Mar, Critical Care Department, CIBER Enfermedades Respiratorias, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Hospital Dr. Peset, Critical Care Department, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Hospital Gregorio Mara¿nón, Critical Care Department, CIBER Enfermedades Respiratorias, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Hospital Rio Hortega, Critical Care Department, CIBER Enfermedades Respiratorias, Valladolid, Spain" "etiqueta" => "<span class="elsevierStyleSup">g</span>" "identificador" => "aff0035" ] 7 => array:3 [ "entidad" => "Hospital del Henares, Critical Care Department, Madrid, Spain" "etiqueta" => 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Respiratorias, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">m</span>" "identificador" => "aff0065" ] 13 => array:3 [ "entidad" => "Critical Care Department, Hospital Universitario de Valme, Sevilla, Spain" "etiqueta" => "<span class="elsevierStyleSup">n</span>" "identificador" => "aff0070" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "fn1" "etiqueta" => "*" "notaPie" => "<p class="elsevierStyleNotepara">Members are listed in the acknowledgements section.</p>" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Primera epidemia de gripe estacional después de la pandemia por gripe A en 2009: descripción de los primeros 300 ingresos en UCI espa¿nolas" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2011-03-08" "fechaAceptado" => "2011-03-10" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec10629" "palabras" => array:3 [ 0 => "An/H1N1 influenza" 1 => "Critically ill patients" 2 => "Prognostic" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec10628" "palabras" => array:3 [ 0 => "Nueva Gripe An/H1N1" 1 => "Pacientes críticos" 2 => "Pronóstico" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">During the 2009 influenza pandemic, several reports were published, nevertheless, data on the clinical profiles of critically ill patients with the new virus infection during this second outbreak are still lacking.</p> <span class="elsevierStyleSectionTitle">Material methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Prospective, observational, multi-center study conducted in 148 Spanish intensive care units (ICU) during epidemiological weeks 50–52 of 2010 and weeks 1–4 of 2011.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Three hundred patients admitted to an intensive care unit (ICU) with confirmed An/H1N1 infection were analyzed. The median age was 49 years [IQR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>38–58] and 62% were male. The mean APACHE II score was 16.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.5 and the mean SOFA score was 6.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.5 on admission. Comorbidities were present in 76% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>228) of cases and 111 (37.4%) patients were reportedly obese and 59 (20%) were COPD. The main presentation was viral pneumonia with severe hypoxemia in 65.7% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>197) of the patients whereas co-infection was identified in 54 (18%) patients. All patients received antiviral treatment and initiated empirically in 194 patients (65.3%), however only 53 patients (17.6%) received early antiviral treatment. Vaccination was only administered in 22 (7.3%) patients. Sixty-seven of 200 patients with ICU discharge died. Haematological disease, severity of illness, infiltrates in chest X-ray and need for mechanical ventilation were variables independently associated with ICU mortality.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In patients admitted to the ICU in the post-pandemic seasonal influenza outbreak vaccination was poorly implemented and appear to have higher frequency of severe comorbidities, severity of illness, incidence of primary viral pneumonia and increased mortality when compared with those observed in the 2009 pandemic outbreak.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Durante la pandemia de gripe A, se publicaron diferentes comunicaciones. No obstante, el perfil clínico de los pacientes críticos afectados por este virus durante este segundo brote epidémico es poco conocido.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo, observacional y multicéntrico realizado en 148 UCI espa¿nolas entre las semanas epidemiológicas 50 de 2010 y 4 de 2011.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se incluyó a los primeros 300 pacientes ingresados en UCI con infección confirmada por An/H1N1. La media de edad fue de 49 [38–58] a¿nos y el 62% eran varones. La media de APACHE II fue 16,9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7,5, con una media de SOFA de 6,3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3,5. El 76% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>228) de los pacientes presentaron alguna comorbilidad, 111 (37,4%) eran obesos y 59 (20%) presentaban EPOC. La presentación clínica más habitual fue la neumonía viral con hipoxemia severa (65,7%; n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>197), mientras que se observó coinfección en 54 pacientes (18%). Todos recibieron tratamiento antiviral, de forma empírica en 194 (65,3%). Sólo 53 pacientes (17,6%) recibieron tratamiento antiviral precoz; 22 pacientes (7,3%) estaban vacunados. Cumplieron su evolución en UCI 200 pacientes, y fallecieron 67 de ellos. La enfermedad hematológica, la gravedad general, los infiltrados en la radiografía de tórax y la necesidad de ventilación mecánica fueron las variables asociadas de forma independiente con la mortalidad.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los pacientes críticos ingresados en UCI durante el brote estacional de gripe pospandémica evidenciaron escaso nivel de vacunación, mayor frecuencia de comorbilidades, un nivel gravedad más elevado, mayor incidencia de neumonía viral primaria y una mortalidad superior en comparación con lo observado durante la pandemia de 2009.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| Year/Month | Html | Total | |
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| 2024 November | 6 | 15 | 21 |
| 2024 October | 41 | 59 | 100 |
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| 2024 May | 36 | 28 | 64 |
| 2024 April | 40 | 40 | 80 |
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| 2023 December | 31 | 41 | 72 |
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| 2023 October | 25 | 31 | 56 |
| 2023 September | 24 | 27 | 51 |
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