Eastern J Med. 2018; 23(3): 168-176 | DOI: 10.5505/ejm.2018.04834

Mortality and severity related factors during the admission: H1N1 pneumonia

Hanifi Yýldýz¹, Selami Ekin¹, Ahmet Arýsoy¹, Hüseyin Akdeniz², Hasan Ali Gümrükçüoðlu³, Selvi Aþker¹, Aysel Sünnetçioðlu¹, Hülya Günbatar¹, Nureddin Yüzkat⁴, Mehmet Hakan Bilgin⁵, Mesut Özgökçe², Mahfuz Turan^6
1Yuzuncu Yil University Faculty of Medicine, Department of Chest Disease, Van, Turkey
²Yuzuncu Yil University Faculty of Medicine, Department of Radiology, Van, Turkey
³Private Lokman Hekim Hospital, Departmen of Cardiology, Van, Turkey
⁴Yuzuncu Yil University Faculty of Medicine, Department of Anesthesiology, Van, Turkey
⁵Private Lokman Hekim Hospital, Departmen of Chest disease, Van, Turkey
⁶Yuzuncu Yil University Faculty of Medicine, Department of Otorhinolaryngology, Van, Turkey

INTRODUCTION: In our country, fatal cases of H1N1 pneumonia were detected between 2015-2016 years. Our aim is to analyze the mortality and severity related factors, during admission of these patients.
METHODS: By conducting a retrospective analysis, 17 cases, confirmed to have H1N1 pneumonia, included in the study. Findings were compared in terms of ARDS and mortality.
RESULTS: ICU and hospital mortality rates were 50% and 30%. The mean age of patients was 50 years. Serum LDH, CK, CK-MB, CRP AST, ALT levels, and the neutrophil-to-lymphocyte ratio (NLR) were found to be increased. In terms of co-infections, there wasn't a significant difference between died and survived patients. The mortality rate was 50% in patients with ARDS. Tere was no relationship between hospital stay with mortality. The symptom of restlessness was related to mortality, and presence of ARDS (P<.05). In died and alive patients, the mean-ranks of PaO2, SpO2, and CURB-65 scores were 3.5, 9.7, 4.3, 10.96, 14.6, and 6.6, respectively (P<.05). PaO2 and SpO2 values were lower, and CURB-65 scores were higher in dead patients. SpO2 <79.5, PaO2 <62.5, and CURB-65 scores ≥2 were related to mortality (P<.05). However, CURB-65 <2 didn’t exclude severe pneumonia. There wasn't a relationship between comorbid diseases and mortality. The main radiographic finding was bilateral infiltrates.
DISCUSSION AND CONCLUSION: This study suggests that PaO2, SpO2, and CURB scores of ≥2 and the presence of restlessness can be used to predict the severity and mortality in patients suspected to have H1N1 pneumonia, during admission.

Keywords: Influenza A Virus H1N1 Subtype, Pneumonia Viral, Severe Acute Respiratory Syndrome, Signs and Symptoms

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