Pandemic Influenza (H1N1) 2009 Pneumonia CURB-65 Score for Predicting Severity and Nasopharyngeal Sampling for Diagnosis Are Unreliable 英文参考文献.docVIP

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Pandemic Influenza (H1N1) 2009 Pneumonia CURB-65 Score for Predicting Severity and Nasopharyngeal Sampling for Diagnosis Are Unreliable 英文参考文献.doc

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Pandemic Influenza (H1N1) 2009 Pneumonia CURB-65 Score for Predicting Severity and Nasopharyngeal Sampling for Diagnosis Are Unreliable 英文参考文献

PandemicInfluenza(H1N1)2009Pneumonia:CURB-65 ScoreforPredictingSeverityandNasopharyngeal SamplingforDiagnosisAreUnreliable SiobhainMulrennan1*,SimoneSaraTempone2,IvanThianWaiLing1,SimonHedleyWilliams2, Gek-ChooGan3,RonanJohnMurray2,4,DavidJohnSpeers2,4,5 1DepartmentofRespiratoryMedicine,SirCharlesGairdnerHospital,Nedlands,WesternAustralia,Australia,2DepartmentofMicrobiology,PathWestLaboratoryMedicine WesternAustralia,Nedlands,WesternAustralia,Australia,3DepartmentofRadiology,SirCharlesGairdnerHospital,Nedlands,WesternAustralia,Australia,4Department ofInfectiousDiseases,SirCharlesGairdnerHospital,Nedlands,WesternAustralia,Australia,5DepartmentofMedicineandPharmacology,UniversityofWesternAustralia, Crawley,WesternAustralia,Australia Abstract Background: From the first case reportsof pandemic influenza (H1N1) 2009 it wasclear that asignificant proportion of infectedindividualssufferedaprimaryviralpneumonia.Theobjectiveofthisstudywastwofold;toassesstheutilityofthe CURB-65communityacquiredpneumonia(CAP)severityindexinpredictingpneumoniaseverityandICUadmission,andto assess the relative sensitivity of nasopharyngeal versus lower respiratory tract sampling for the detection of pandemic influenza(H1N1)CAP. Methods:Aretrospectivecohortstudyof70patientshospitalisedforpandemicinfluenza(H1N1)2009inanadulttertiary referralhospital.Characteristicsevaluatedincludedage,pregnancystatus,sex,respiratorysignsandsymptoms,smoking andalcoholhistory,CURB-65score,co-morbidities,disablingsequelae,lengthofstayandin-hospitalmortalityoutcomes. Laboratoryfeaturesevaluatedincludedlymphocytecount,C-reactiveprotein(CRP),nasopharyngealandlowerrespiratory tractpandemicinfluenza(H1N1)2009PCRresults. Results:Patientswithpandemic(H1N1)2009influenzaCAPdifferedsignificantlyfromthosewithoutpneumoniaregarding lengthofstay,needforICUadmission,CRPandthelikelihoodofdisablingsequelae.TheCURB-65scoredidnotpredictCAP severityortheneedforICUadmission(only2/11patientsadmittedtoICUhadCURB-65scoresof2or3).Nasopharyn