응급실에 내원한 H1N1 인플루엔자 감염 환자의 연도별 임상 특성: 일개 응급의료센터 관찰연구
- 응급실에 내원한 H1N1 인플루엔자 감염 환자의 연도별 임상 특성: 일개 응급의료센터 관찰연구
- Other Titles
- Comparison of the Clinical Characteristics of the Patients Visited in Emergency Department with Pandemic 2009 Influenza A (H1N1) Virus Infection during the First Three Years; An Observational Study at a Single Emergency Department
- 도병수; 이삼범; 박신률; 남상서[남상서]
- .; Influenza A virus subtype H1N1; Pandemics; Epidemiology
- Issue Date
- 대한응급의학회지, v.25, no.1, pp.84 - 89
- Purpose: Daegu, Korea was severely affected by pandemicand post-pandemic H1N1 infection during August 2009 toMarch 2012. The aim of this study was to analyze variousclinical characteristics of patients who visited the emergencydepartment with H1N1 infection during the first threeyears, and to compare the results for each year. We thenperformed an evaluation of the differences.
Methods: The medical records of patients who visited ouremergency department and conformed to H1N1 virus infectionby conventional rRT-PCR during the pandemic wavefrom August 2009 to March 2010(wave 1) and post-pandemicwaves from August 2010 to March 2011(wave 2)and from August 2011 to March 2012(wave 3) werereviewed. A total of 986 patients (wave 1; 840, wave 2; 144,wave 3; 2) were included in this study. We analyzed theclinical characteristics, proportions of pneumonia, admissionrate, relationships with underlying medical conditions,and requirement for mechanical ventilation of the infectedpatients, and then performed a statistical evaluation of thedifferences between wave 1 and wave 2 that was severelyaffected.
Results: During wave 1,840 patients, during wave 2, 144patients, and during wave 3, two patients were diagnosed asnovel influenza. Age 18-39 showed a significantly higherrate(78.7%) in the wave 1 patients group. Main clinical symptomswere cough and febrile sense in both waves. Patientswith underlying medical conditions in wave 2(97 cases,67.4%) showed a higher rate than those of wave 1(101cases, 12.0%). Chronic obstructive pulmonary disorder wasthe most closely related underlying disorder in wave2(18.8%). Patients requiring admission(37.5%) and ventilatorycare(6.9%) due to severe pneumonic symptoms showed asignificantly higher rate in wave 2. Only two young patientswere diagnosed as novel influenza. Both complained of mildfever and cough, which recovered spontaneously.
Conclusion: Most cases of influenza A (H1N1) infectionwere uncomplicated, characterized by influenza-like symptomsand spontaneous recovery. The number of patientsshowed a marked decreased year by year, however, theseverity of clinical presentations increased in wave 2. Youngadults who did not have cross-reactive antibodies to novelinfluenza A (H1N1) from previous infection or immunizationwere dominant in wave 1. Older patients with underlyingmedical conditions were more likely to admitted and presentfatal progress in wave 1 and wave 2. Because influenzaviruses are unpredictable, continued national preparedness,flexible response, and careful monitoring are essential.
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