Burden of critically ill patients with influenza in a French catchment population

Sci Rep. 2021 May 18;11(1):10526. doi: 10.1038/s41598-021-89912-y.

Abstract

Despite the particular focus given to influenza since the 2009 influenza A(H1N1) pandemic, true burden of influenza-associated critical illness remains poorly known. The aim of this study was to identify factors influencing influenza burden imposed on intensive care units (ICUs) in a catchment population during recent influenza seasons. From 2008 to 2013, all adult patients admitted with a laboratory-confirmed influenza infection to one of the ICUs in the catchment area were prospectively included. A total of 201 patients (mean age: 63 ± 16, sex-ratio: 1.1) were included. The influenza-related ICU-bed occupancy rate averaged 4.3% over the five influenza seasons, with the highest mean occupancy rate (16.9%) observed during the 2012 winter. In-hospital mortality for the whole cohort was 26%. Influenza A(H1N1)pdm infections (pdm in the mentioned nomenclature refers to Pandemic Disease Mexico 2009), encountered in 51% of cases, were significantly associated with neither longer length of stay nor higher mortality (ICU and hospital) when compared to infections with other virus subtypes. SOFA score (OR, 1.12; 95% CI, 1.04-1.29) was the only independent factor significantly associated with a prolonged hospitalization. These results highlight both the frequency and the severity of influenza-associated critical illness, leading to a sustained activity in ICUs. Severity of the disease, but not A(H1N1)pdm virus, appears to be a major determinant of ICU burden related to influenza.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Bed Occupancy / statistics & numerical data
  • Catchment Area, Health*
  • Cohort Studies
  • Critical Illness*
  • Female
  • France / epidemiology
  • Humans
  • Influenza A virus / isolation & purification
  • Influenza B virus / isolation & purification
  • Influenza, Human / epidemiology*
  • Influenza, Human / virology
  • Intensive Care Units
  • Male
  • Middle Aged
  • Prospective Studies
  • Seasons