Intensive Care Medicine

, 37:1746

Is influenza A(H1N1) pneumonia more severe than other community-acquired pneumonias? Results of the GiViTI survey of 155 Italian ICUs

  • Guido Bertolini
  • Carlotta Rossi
  • Daniele Crespi
  • Stefano Finazzi
  • Marco Morandotti
  • Sandra Rossi
  • Mario Peta
  • Martin Langer
  • Daniele Poole
Original

DOI: 10.1007/s00134-011-2339-5

Cite this article as:
Bertolini, G., Rossi, C., Crespi, D. et al. Intensive Care Med (2011) 37: 1746. doi:10.1007/s00134-011-2339-5

Abstract

Purpose

Uncertainty about the severity of the A(H1N1) pandemia persists. Information about disease severity can be obtained by investigating intensive care unit (ICU) admissions, especially when historical comparisons can be made with cases of community-acquired pneumonia (CAP).

Methods

This prospective observational study was conducted in 155 ICUs contributing to the GiViTI national database. To assess the impact on ICU workload, the occupancy rate during the epidemic phase was compared with influenza periods in previous years. A logistic regression model was developed to assess the prognostic importance of A(H1N1) influenza.

Results

The characteristics of the 319 A(H1N1) cases were similar to those reported in other studies, confirming the young age of patients (mean 43 years) and the higher prevalence among pregnant women and obese people. At the epidemic’s peak (October–December 2009) the occupancy rate did not significantly differ from the same period of the previous year, and was significantly lower than the 2009 seasonal influenza outbreak (January–March 2009). Compared with CAP of other origin (3,678 patients), A(H1N1) pneumonia was associated with a lower risk of death. However, after adjusting for confounding this was no longer the case (OR 0.88; 95% CI 0.59–1.31; p = 0.52).

Conclusion

This study confirmed the specific features of critically ill A(H1N1) patients (i.e., young age, pregnancy, obesity). The pandemic did not increase ICU workload compared with other periods. A(H1N1) pneumonia did not have a higher risk of death than CAP of different origin among patients admitted to the ICU.

Keywords

Intensive care unitsInfluenza A(H1N1)MortalityBed occupancy

Supplementary material

134_2011_2339_MOESM1_ESM.doc (162 kb)
Supplementary material 1 (DOC 162 kb)

Copyright information

© Copyright jointly held by Springer and ESICM 2011

Authors and Affiliations

  • Guido Bertolini
    • 1
  • Carlotta Rossi
    • 1
  • Daniele Crespi
    • 1
  • Stefano Finazzi
    • 2
  • Marco Morandotti
    • 2
  • Sandra Rossi
    • 3
  • Mario Peta
    • 4
  • Martin Langer
    • 5
  • Daniele Poole
    • 6
  1. 1.GiViTI Coordinating CenterIstituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare Aldo e Cele DaccòRanicaItaly
  2. 2.SISSATriesteItaly
  3. 3.UOC Istituto di Anestesia e RianimazioneAzienda Ospedaliera di PadovaPadovaItaly
  4. 4.Servizio Anestesia e RianimazioneOspedale Regionale Ca’ FoncelloTrevisoItaly
  5. 5.Fondazione IRCCS Istituto Nazionale TumoriUniversità degli Studi di MilanoMilanItaly
  6. 6.Servizio Anestesia e RianimazioneOspedale Civile San MartinoBellunoItaly