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Predictors of severe H1N1 infection in children presenting within Pediatric Emergency Research Networks (PERN): retrospective case-control study.

Abstract：

OBJECTIVE:To identify historical and clinical findings at emergency department presentation associated with severe H1N1 outcome in children presenting with influenza-like illness. DESIGN:Multicentre retrospective case-control study. SETTING:79 emergency departments of hospitals associated with the Pediatric Emergency Research Networks in 12 countries. PARTICIPANTS:265 children (<16 years), presenting between 16 April and 31 December 2009, who fulfilled Centers for Disease Control and Prevention criteria for influenza-like illness and developed severe outcomes from laboratory confirmed H1N1 infection. For each case, two controls presenting with influenza-like illness but without severe outcomes were included: one random control and one age matched control. MAIN OUTCOME MEASURES:Severe outcomes included death or admission to intensive care for assisted ventilation, inotropic support, or both. Multivariable conditional logistic regression was used to compare cases and controls, with effect sizes measured as adjusted odds ratios. RESULTS:151 (57%) of the 265 cases were male, the median age was 6 (interquartile range 2.3-10.0) years, and 27 (10%) died. Six factors were associated with severe outcomes in children presenting with influenza-like illness: history of chronic lung disease (odds ratio 10.3, 95% confidence interval 1.5 to 69.8), history of cerebral palsy/developmental delay (10.2, 2.0 to 51.4), signs of chest retractions (9.6, 3.2 to 29.0), signs of dehydration (8.8, 1.6 to 49.3), requirement for oxygen (5.8, 2.0 to 16.2), and tachycardia relative to age). CONCLUSION:These independent risk factors may alert clinicians to children at risk of severe outcomes when presenting with influenza-like illness during future pandemics.

journal_name

BMJ

journal_title

BMJ (Clinical research ed.)

authors

Dalziel SR,Thompson JM,Macias CG,Fernandes RM,Johnson DW,Waisman Y,Cheng N,Acworth J,Chamberlain JM,Osmond MH,Plint A,Valerio P,Black KJ,Fitzpatrick E,Newton AS,Kuppermann N,Klassen TP,Pediatric Emergency Research Netwo

doi

10.1136/bmj.f4836

subject

Has Abstract

pub_date

2013-08-12 00:00:00

pages

f4836

eissn

0959-8138

issn

1756-1833

journal_volume

347

pub_type

杂志文章,多中心研究

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Predictors of severe H1N1 infection in children presenting within Pediatric Emergency Research Networks (PERN): retrospective case-control study.