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Korean J Crit Care Med > Volume 27(2); 2012 > Article
Korean Journal of Critical Care Medicine 2012;27(2): 65-69. doi: https://doi.org/10.4266/kjccm.2012.27.2.65
중환자실 구성이 2009년 인플루엔자 A/H1N1 중증환자의 사망률에 미친 영향
조재화ㆍ이훈재*ㆍ홍상범†ㆍ서지영‡ㆍ박무석§ㆍ김석찬∥ㆍ곽상현¶ㆍ이명구**ㆍ임재민†ㆍ이현경††ㆍ고윤석†ㆍ대한중환자학회H1N1연구회
인하대학교 의학전문대학원 내과학교실, *사회의학교실, †울산대학교 의과대학 내과학교실, ‡성균관대학교 의과대학 내과학교실, §연세대학교 의과대학 내과학교실, ∥가톨릭대학교 의과대학 내과학교실, ¶전남대학교 의학전문대학원 마취통증의학과, **한림대학교 의과대학 내과학교실, ††인제대학교 의과대학 내과학교실
Structure of Intensive Care Unit and Clinical Outcomes in Critically Ill Patients with Influenza A/H1N1 2009
Jaehwa Cho, Hun Jae Lee, Sang Bum Hong, Gee Young Suh, Moo Suk Park, Seok Chan Kim, Sang Hyun Kwak, Myung Goo Lee, Jae Min Lim, Huyn Kyung Lee, Younsuck Koh
1Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
2Department of Preventive and Social Mecine, Inha University School of Medicine, Incheon, Korea.
3Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea. yskoh@amc.seoul.kr
4Department of Internal Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea.
5Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
6Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
7Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Korea.
8Department of Internal Medicine, Hallym Univerity College of Medicine, Chuncheon, Korea.
9Department of Internal Medicine, Inje University College of Medicine, Busan, Korea.
ABSTRACT
BACKGROUND: During 2009 pandemic period, many Koreans were infected and admitted with Influenza A/H1N1. The primary aim of this study was to evaluate whether the structures of an intensive care unit (ICU) were associated with the outcomes of critically ill patients. METHODS: This retrospective observational study examined critically ill adult patients with influenza A/H1N1, who were admitted to 24 hospitals in Korea, from September 2009 to February 2010. We collected data of ICU structure, patients and 90 days mortality. Univariate and multivariate logistic regression analysis, with backward elimination, were performed to determine the most significant risk factors. RESULTS: Of the 239 patients, mortality of 90 days was 43%. Acute physiology and chronic health evaluation (APACHE) II score (p < 0.001), sequential organ failure assessment (SOFA) score (p < 0.0001), nurse to beds ratio (p = 0.039) and presence of intensivist (p = 0.024) were significant risk factors of 90 days mortality. Age (p = 0.123), gender (p = 0.304), hospital size (p = 0.260), and ICU type (p = 0.409) were insignificantly associated with mortality. In a multivariate logistic regression analysis, patients with less than 6 SOFA score had significantly lower mortality, compared with those with more than 10 SOFA score (odds ratio 0.156, p < 0.0001). The presence of intensivist had significantly lower mortality, compared with the absence (odds ratio 0.496, p = 0.026). CONCLUSIONS: In critically ill patients with influenza A/H1N1, the severity of the illness and presence of intensivist might be associated with 90 days mortality.
Key Words: ICU; influenzae; intensivist; mortality
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