Risk factors associated with death in patients with severe respiratory syncytial virus infection

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• 作者：Yen-I Lee^a ; Chun-Chih Peng^a ; ^b ; Nan-Chang Chiu^a ; ^c ; Daniel Tsung-Ning Huang^a ; ^d ; Fu-Yuan Huang^a ; Hsin Chi^a ; ^b ; ^c ; ^d ; ^{chi.4531@mmh.org.tw" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Down's syndrome ; mortality ; nosocomial infection ; respiratory syncytial virus ; risk factors
• 刊名：Journal of Microbiology, Immunology and Infection
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：49
• 期：5
• 页码：737-742
• 全文大小：272 K

文摘

Respiratory syncytial virus (RSV) infection is an important cause of viral respiratory tract infection in children. This retrospective study describes the clinical characteristics of severe RSV infection and determines the risk factors for death.

Methods

Patients were identified through a review of all patients discharged with a diagnosis of RSV lower respiratory tract infection and admitted to hospital in the pediatric intensive care unit (PICU) of a tertiary medical center between July 1, 2001 and June 30, 2010. The medical and demographic variables were recorded and analyzed.

Results

The 186 RSV-positive patients admitted to the PICU had a median age of 5.3 months (interquartile range 2.3–12.4 months) and included 129 boys and 57 girls. Among them, 134 had at least one underlying disease: prematurity in 92, neurological disease in 57, bronchopulmonary dysplasia in 40, congenital heart disease in 26, hematological malignancies in 11, and Down's syndrome in nine patients. The 10 patients who died from RSV-related causes had a median age of 20.8 months (interquartile range 6.6–89.2 months) and all had a comorbidity. In multivariate analysis, the risk factors for death in severe RSV infection were Down's syndrome (odds ratio 7.20, 95% confidence interval 1.13–45.76; p = 0.036) and nosocomial RSV infection (odds ratio 4.46, 95% confidence interval 1.09–18.27; p = 0.038).

Conclusion

Down's syndrome and nosocomial RSV infection are significantly associated with death in severe RSV infections. Clinicians should be alert to these conditions.