Critically Ill Patients with H1N1 Pneumonia: Two Year Experience in a Tertiary Level Indian ICU

Abstract

Purpose: To learn about the clinical profile, outcome and quality of life and factors influencing these, in critically ill patients with H1N1 pneumonia. Methods: Retrospective analysis of case files and phone interview of 88patients with confirmed H1N1 pneumonia. Results: Out of 88 patients, 51 were males. Mean age was 48.23 [± 13.03]. 39 [44.31%] were in the 31-50 years age group and 37 [42.04%] were in the 51-70 age group. Diabetes [n=16] and Hypertension [n=20] were the most common comorbidities. Majority of the patients presented with cough [n=87], breathlessness [n=85] and fever [n=84]. 43 patients had severe ARDS on admission. Mean APACHE II score was 9.6 [± 5.4] Mean SOFA scores 4.99 [± 2.6]. Mean Murray score was 2.37 [± 0.76]. 46 patients [52%] survived. Factors associated with mortality were APACHE score [p=0.00], SOFA score [p=0.00] Murray score, severe ARDS [p=0.00], requirement of vasopressor support [p=0.00] or renal replacement therapy [p=0.00] and incidence of VAP [p=0.039]. Diabetes had a protective effect [p=0.04], as had non-invasive ventilation [p=0.00]. Murray score [p=0.000, SOFA score [p=0.036], initiation of mechanical ventilation [p=0.003] and incidence of VAP [p=0.00] was associated with increased length of stay among the survivors. Conclusion: Higher lung specific severity scores, severe ARDS, secondary organ failure and VAP were associated with increased mortality. Among survivors, higher Murray and SOFA scores, mechanical ventilation and vasopressor use entailed a longer ICU stay.