Differences between asthmatics and nonasthmatics hospitalised with influenza A infection

Myles, P. et al. (2013) Differences between asthmatics and nonasthmatics hospitalised with influenza A infection. European Respiratory Journal, 41(4), pp. 824-831. (doi: 10.1183/09031936.00015512)

Abstract

<p>Asthmatics hospitalised because of influenza A infection are less likely to require intensive care or die compared with nonasthmatics. The reasons for this are unknown.</p> <p>We performed a retrospective analysis of data on 1520 patients admitted to 75 UK hospitals with confirmed influenza A/H1N1 2009 infection. A multivariable model was used to investigate reasons for the association between asthma and severe outcomes (intensive care unit support or death).</p> <p>Asthmatics were less likely than nonasthmatics to have severe outcome (11.2% versus 19.8%, unadjusted OR 0.51, 95% CI 0.36–0.72) despite a greater proportion requiring oxygen on admission (36.4% versus 26%, unadjusted OR 1.63) and similar rates of pneumonia (17.1% versus 16.6%, unadjusted OR 1.04). The results of multivariable logistic regression suggest the association of asthma with outcome (adjusted OR 0.62, 95% CI 0.36–1.05; p=0.075) are explained by pre-admission inhaled corticosteroid use (adjusted OR 0.34, 95% CI 0.18–0.66) and earlier admission (≤4 days from symptom onset) (adjusted OR 0.60, 95% CI 0.38–0.94). In asthmatics, systemic corticosteroids were associated with a decreased likelihood of severe outcomes (adjusted OR 0.36, 95% CI 0.18–0.72).</p> <p>Corticosteroid use and earlier hospital admission explained the association of asthma with less severe outcomes in hospitalised patients.</p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McMenamin, Dr James
• Authors: Myles, P., Nguyen-Van-Tam, J.S., Semple, M.G., Brett, S.J., Bannister, B., Read, R.C., Taylor, B.L., McMenamin, J., Enstone, J.E., Nicholson, K.G., Openshaw, P.J., and Lim, W.S.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: European Respiratory Journal
• Publisher: European Respiratory Society
• ISSN: 0903-1936
• ISSN (Online): 1399-3003
• Copyright Holders: Copyright © 2013 European Respiratory Society
• First Published: First published in European Respiratory Journal 41(4):824-831
• Publisher Policy: Reproduced under a Creative Commons License