Clinical epidemiology and predictors of outcome in children hospitalised with influenza A(H1N1)pdm09 in 2009: a prospective national study
MetadataShow full item record
Background There are few large-scale, prospective studies of influenza A(H1N1)pdm09 in children that identify predictors of adverse outcomes. Objectives We aimed to examine clinical epidemiology and predictors for adverse outcomes in children hospitalised with influenza A(H1N1)pdm09 in Australia. Methods Active hospital surveillance in six tertiary paediatric referral centres (June-September, 2009). All children aged <15 years admitted with laboratory-confirmed influenza A(H1N1)pdm09 were studied. Results Of 601 children admitted with laboratory-confirmed influenza, 506 (84粥) had influenza A(H1N1)pdm09. Half (51簥) of children with influenza A(H1N1)pdm09 were previously healthy. Hospital stay was longer in children with pre-existing condition (mean 6繠versus 4繠days; P = 0簲) as was paediatric intensive care unit (PICU) stay (7簠versus 2糠days; P = 0簰5). Rapid diagnosis decreased both antibiotic use and length of hospital and PICU stay. Fifty (9繥) children were admitted to a PICU, 30 (5繥) required mechanical ventilation and 5 (0繥) died. Laboratory-proven bacterial co-infection and chronic lung disease were significant independent predictors of PICU admission (OR 6縹, 95% CI 3籵-15簶 and OR 3絸, 95% CI 1紱-9簷, respectively) and requirement for ventilation (OR 5綱, 95% CI 2粭14粸 and OR 5籸, 95% CI 1縭14縶, respectively). Chronic neurological disease was a predictor of admission to PICU (OR 2糰, 95% CI 1籴-4綱). Conclusions During the 2009 pandemic, influenza was a major cause of hospitalisation in tertiary paediatric hospitals. Co-infection and underlying chronic disease increased risk of PICU admission and/or ventilation. Half the children admitted were previously healthy, supporting a role for universal influenza vaccination in children.
Influenza and Other Respiratory Viruses
© 2014 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.