Demographic and laboratory variables and their effect on mortality in influenza A (H1N1)pdm09 outbreak in 2015 in Rajasthan, India

Abstract

Abstract Introduction Influenza A (H1N1)pdm09 outbreaks cause considerable morbidity and mortality. There is an unmet need to ascertain the prognostic factors. Material and method In 425 confirmed cases of influenza A (H1N1)pdm09 hospitalized during December 2014 to March 2015, demographic data, clinical presentation, comorbidities and laboratory values at the presentation were studied to determine factors associated with mortality. Result Out of 425 cases, 309 survived and 116 expired (27.20%). Of 112 patients (26.35%) who were hospitalized within 3 days of symptom onset, 18 died (16.03%), but of 313 (73.65%) who presented after 3 days, 98 (31.30%) died (p Presence of at least one major organ dysfunction had higher mortality than those who did not (60.55% versus 2.85%, p Conclusion Factors associated with higher mortality were delay in hospitalization and initiation of oseltamivir, male sex, younger age, higher clinical category of disease, presence of leucocytosis or any major organ dysfunction. Higher serum levels of urea, creatinine, AST, ALT, CPK and LDH were strongly associated with mortality.