Retrospective Analysis Of Prognostic Factors In 22 Patients With Severe Influenza A H1N1

Objective:to analyze the clinical data of severe influenza A(H1N1)cases and to explore the prognostic factors of severe influenza A(H1N1).Methods:the clinical data of 22 cases of severe influenza A(H1N1)confirmed by nasopharyngeal swab RT-PCR laboratory were retrospectively analyzed.According to the prognosis of 30 days,the patients were divided into survival group and death group.The difference of appeal indexes between survival group and death group was compared,and the factors influencing the prognosis of severe influenza A(H1N1)were analyzed.Results:The median age and quartile spacing of the patients in the death group were 65(63 / 69),which were significantly higher than that in the survival group 58(47 / 63)(P=0.032).The majority of the patients in the death group(> 65 years old)were the elderly(55.56%).The survival group consisted mainly of middle-aged patients(41-64 years old)(69.24%),deathcombination and dyspnea(P=0.046),liver and kidney insufficiency(P=0.006),sepsis(P=0.023).The proportion of coagulation dysfunction(P=0.017)was significantly higher than that of survival group,the oxygenation index of death group was significantly lower than that of survival group,and the proportion of patients with oxygen pressure less than 150 mmHg was significantly higher than that of survival group(P=0.004).Compared with the survival group,the lymphocyte(P=0.008),monocyte(P=0.049)levels and the percentage of neutrophils(P=0.049)in the dead group were significantly lower than those in the survival group.The incidence of hospital sensation was high(P=0.026).The acute physiology and chronic health status scoring system ? APACHE ? in the death group was higher22(21 / 27)than that in the survival group12(10,14),(P=0.000).The percentage of patients with APACHE ? score > 20 in the death group was significantly higher than that in the survival group.COX multivariate regression analysis showed that the APACHII score(P=0.033,HR=3.160),the percentage of neutrophils 1 week later(P=0.040,HR=1.217)has a significant correlation with the 30-day death of patients and is the independent factors affecting the death of patients.Conclusion:Low immunity,strong inflammatory response,accompanied by dyspnea,complicated with basic diseases,APACH ? score > 20,oxygenation index less than 150,complicated with infection,liver andkidney insufficiency,sepsis.Clotting dysfunction and other factors are closely related to the prognosis of severe influenza A H1N1.