The DOI matches its Crossref record; 47 of the 47 references it cites were found in a registry or an index.
Critically Ill Patients With 2009 Influenza A(H1N1) Infection in Canada
Abstract
CONTEXT: Between March and July 2009, the largest number of confirmed cases of 2009 influenza A(H1N1) infection occurred in North America. OBJECTIVE: To describe characteristics, treatment, and outcomes of critically ill patients in Canada with 2009 influenza A(H1N1) infection. DESIGN, SETTING, AND PATIENTS: A prospective observational study of 168 critically ill patients with 2009 influenza A(H1N1) infection in 38 adult and pediatric intensive care units (ICUs) in Canada between April 16 and August 12, 2009. MAIN OUTCOME MEASURES: The primary outcome measures were 28-day and 90-day mortality. Secondary outcomes included frequency and duration of mechanical ventilation and duration of ICU stay. RESULTS: Critical illness occurred in 215 patients with confirmed (n = 162), probable (n = 6), or suspected (n = 47) community-acquired 2009 influenza A(H1N1) infection. Among the 168 patients with confirmed or probable 2009 influenza A(H1N1), the mean (SD) age was 32.3 (21.4) years; 113 were female (67.3%) and 50 were children (29.8%). Overall mortality among critically ill patients at 28 days was 14.3% (95% confidence interval, 9.5%-20.7%). There were 43 patients who were aboriginal Canadians (25.6%). The median time from symptom onset to hospital admission was 4 days (interquartile range [IQR], 2-7 days) and from hospitalization to ICU admission was 1 day (IQR, 0-2 days). Shock and nonpulmonary acute organ dysfunction was common (Sequential Organ Failure Assessment mean [SD] score of 6.8 [3.6] on day 1). Neuraminidase inhibitors were administered to 152 patients (90.5%). All patients were severely hypoxemic (mean [SD] ratio of Pao(2) to fraction of inspired oxygen [Fio(2)] of 147 [128] mm Hg) at ICU admission. Mechanical ventilation was received by 136 patients (81.0%). The median duration of ventilation was 12 days (IQR, 6-20 days) and ICU stay was 12 days (IQR, 5-20 days). Lung rescue therapies included neuromuscular blockade (28% of patients), inhaled nitric oxide (13.7%), high-frequency oscillatory ventilation (11.9%), extracorporeal membrane oxygenation (4.2%), and prone positioning ventilation (3.0%). Overall mortality among critically ill patients at 90 days was 17.3% (95% confidence interval, 12.0%-24.0%; n = 29). CONCLUSION: Critical illness due to 2009 influenza A(H1N1) in Canada occurred rapidly after hospital admission, often in young adults, and was associated with severe hypoxemia, multisystem organ failure, a requirement for prolonged mechanical ventilation, and the frequent use of rescue therapies.
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In the citing paper
“A Canadian study (N = 168) attributed secondary bacterial infection as a leading cause of death in the 29 (17.3%) fatalities that occurred in this cohort [33].”
From The role of pneumonia and secondary bacterial infection in fatal and serious outcomes of pandemic influenza a(H1N1)pdm09. (2018) · cites this paper as [33]
In the citing paper
“Bacterial co-infection was also detected in ~30% of cases in the 2009 H1N1 pandemic, with high mortality rates despite administration of appropriate antibiotics”
From Respiratory viral infection-induced microbiome alterations and secondary bacterial pneumonia. (2018) · cites this paper as [14]
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Yang, X., Yu, Y., Xu, J., Shu, H., Xia, J., Liu, H., Wu, Y., Zhang, L., Yu, Z., Fang, M., et al. (2020) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(20)30079-5 · Cited by 10,066
Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock
Dellinger, R. P., Levy, M. M., Rhodes, A., Annane, D., Gerlach, H., Opal, S. M., Sevransky, J. E., Sprung, C. L., Douglas, I. S., Jaeschke, R., et al. (2013) · Critical Care Medicine · doi:10.1097/ccm.0b013e31827e83af · Cited by 9,694
Dellinger, R. P., Levy, M. M., Rhodes, A., Annane, D., Gerlach, H., Opal, S. M., Sevransky, J., Sprung, C. L., Douglas, I. S., Jaeschke, R., et al. (2013) · Intensive Care Medicine · doi:10.1007/s00134-012-2769-8 · Cited by 7,371
Kidney disease is associated with in-hospital death of patients with COVID-19
Cheng, Y., Luo, R., Wang, K., Zhang, M., Wang, Z., Dong, L., Li, J., Yao, Y., Ge, S., & Xu, G. (2020) · Kidney International · doi:10.1016/j.kint.2020.03.005 · Cited by 3,016
Grohskopf, L. A., Sokolow, L. Z., Broder, K. R., Walter, E. B., Fry, A. M., & Jernigan, D. B. (2018) · MMWR Recommendations and Reports · doi:10.15585/mmwr.rr6703a1 · Cited by 1,640
Metadata
- Authors
- Kumar, A.
- Affiliations
- Health Sciences Centre (CA)
- Corresponding author
- Kumar, Anand
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2009-11-04
- Volume
- 302
- Issue
- 17
- Pages
- 1872
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2148958087
- Cited by
- 1,425
- References
- 47
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 16 · 2023: 23 · 2022: 28 · 2021: 55 · 2020: 89 · 2019: 38 · 2018: 33 · 2017: 35 · 2016: 53 · 2015: 63 · 2014: 74 · 2013: 128 · 2012: 156
- FWCI
- 171.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Thoracic Society
- Alberta Health Services
- Hamilton Health Sciences
- McGill University
- London Health Sciences Centre
- McMaster University
- BC Children's Hospital
- McGill University Health Centre
- University of Alberta
- University of Toronto
- Jewish General Hospital
- Hospital for Sick Children
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Keywords
- pandemic influenza, critically ill patients, intensive care, mortality, mechanical ventilation, hypoxemia, neuraminidase inhibitors, organ dysfunction, shock, Aboriginal Canadians, pediatric patients, treatment outcomes, Canada, influenza A (H1N1) 2009
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Hypoxia, Canada, Child, Child, Preschool, Disease Outbreaks, Female, Humans, Infant, Influenza, Human, Intensive Care Units, Length of Stay, Male, Middle Aged, Multiple Organ Failure, Prospective Studies, Respiration, Artificial, Respiratory Distress Syndrome, Comorbidity, Critical Illness, Age Distribution, Influenza A Virus, H1N1 Subtype, Kaplan-Meier Estimate, Young Adult
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