@article{3183560,
    title = "Using research to prepare for outbreaks of severe acute respiratory
infection",
    author = "Mich, Vann and Pho, Yaty and Bory, Sotharith and Vann, Mich and Teav, and Bunlor and Som, Leakhann and Jarrvisalo, Mikko J. and Pulkkinen, Anni and and Kuitunen, Anne and Ala-kokko, Tero and Melto, Sari and Daix, Thomas and and Philippart, Francois and Antoine, Marchalot and Tiercelet, Kelly and and Bruel, Cedric and Nicholas, Sedillot and Siami, Shidasp and Fabienne, and Taimon and Bruyere, Raomi and Forceville, Xavier and Erickson, Simon and and Campbell, Lewis and Sonawane, Ravikiran and Santamaria, John and Kol, and Mark and Awasthi, Shally and Powis, Jeff and Hall, Richard and McCarthy, and Anne E. and Jouvet, Philippe and Opaysky, Mary Anne and Gilfoyle, Elaine and and Farshait, Nataly and Martin, Dori-Ann and Griesdale, Donald and and Katz, Kevin and Ruberto, Aaron J. and Carrier, Francois Martin and and Lamontagne, Francois and Muscedere, John and Rishu, Asgar and Sin, Wai and Ching and Ngai, Wallace Chun Wai and Young, Paul and Forrest, Annette and and Kazemi, Alex and Henderson, Seton and Browne, Troy and and Ganeshalingham, Anusha and McConnochie, Rachael and Cho, Jae Hwa and and Park, Tai Sun and Sim, Yun Su and Chang, Youjin and Lee, Heung Bum and and Park, Seung Yong and Chan, Wai Ming and Lee, Won-Yeon and Wallace, David and J. and Angus, Derek C. and Charles, Anthony G. and van Doom, H. Rogier and and Nguyen Van Kinh and Nguyen Vu Trung and Prin, Meghan and and Twagirumugabe, Theogene and Umuhire, Olivier Felix and Sylvain, and Habarurema and Al Qasim, Eman and Heraud, Jean-Michel and Raberahona, and Mihaja and Rabarison, Joelinotahiana Hasina and Patrigeon, Santiago and Perez and Ramirez-Venegas, Alejandra and Melendez, Javier Araujo and and Guerrero, M. Lourdes and Mambule, Ivan and Ochieng, Otieno George and and Nadjm, Behzad and Li, Iris Wai Sum and Choi, Won-Il and Florence, and Komurian-Pradel and Arabi, Yaseen M. and West, T. Eoin and Riviello, and Elisabeth D. and Parke, Rachael and Djillali, Annane E. and Fowler, and Robert and Murthy, Srinivas and Nichol, Alistair and Cheng, Allen C. and and Semple, Calum and George, Maya and Valkonen, Miia and McArthur, Colin and and Carson, Gail and O'Neill, Genevieve and Cobb, J. Perren and Dunning, and Jake and Chiche, Jean-Daniel and Huh, Jin-Won and Marshall, John and and Rello, Jordi and Guillebaud, Julia and Razanazatovo, Norosoa and Otieno, and Juilett Wambura and Green, Karen and Rowan, Kathy and Baillie, John and Kenneth and Merson, Laura and Hsu, Li Yang and Christian, Michael D. and and Egi, Moritoki and Shindo, Nahoko and Horby, Peter and Pardinaz-Solis, and Raul and Ubiergo, Sebastian Ugarte and Webb, Steve A. R. and Uyeki, and Timothy M. and Gordon, Anthony C. and Paterson, David L. and Everett, and Dean and Giamarellos-Bourboulis, Evangelos J. and Longuere, Kajsa-Stina and and Maslove, David and Ohuma, Eric and Growl, Gloria and PedutemHumber, and Theresa and EllazarHumber, Edward and Bahinskaya, Ilona and and Osbourne-Townsend, Joan and Bentley, Andrew and Goodson, Jennifer and and Welters, Ingeborg and Malik, Nadia and Browne, T. S. and Mahesh, Vinaya and and SPRINT-SARI Investigators",
    journal = "BMJ Global Health",
    year = "2019",
    volume = "4",
    number = "1",
    publisher = "BMJ Publishing Group",
    issn = "2059-7908",
    doi = "10.1136/bmjgh-2018-001061",
    abstract = "Severe acute respiratory infections (SARI) remain one of the leading
causes of mortality around the world in all age groups. There is large
global variation in epidemiology, clinical management and outcomes,
including mortality. We performed a short period observational data
collection in critical care units distributed globally during regional
peak SARI seasons from 1 January 2016 until 31 August 2017, using
standardised data collection tools. Data were collected for 1 week on
all admitted patients who met the inclusion criteria for SARI, with
follow-up to hospital discharge. Proportions of patients across regions
were compared for microbiology, management strategies and outcomes.
Regions were divided geographically and economically according to World
Bank definitions. Data were collected for 682 patients from 95 hospitals
and 23 countries. The overall mortality was 9.5%. Of the patients,
21.7% were children, with case fatality proportions of 1% for those
less than 5 years. The highest mortality was in those above 60 years, at
18.6%. Case fatality varied by region: East Asia and Pacific 10.2% (21
of 206), Sub-Saharan Africa 4.3% (8 of 188), South Asia 0% (0 of 35),
North America 13.6% (25 of 184), and Europe and Central Asia 14.3% (9
of 63). Mortality in low-income and low-middle-income countries combined
was 4% as compared with 14% in high-income countries. Organ
dysfunction scores calculated on presentation in 560 patients where full
data were available revealed Sequential Organ Failure Assessment (SOFA)
scores on presentation were significantly associated with mortality and
hospital length of stay. Patients in East Asia and Pacific (48%) and
North America (24%) had the highest SOFA scores of >12. Multivariable
analysis demonstrated that initial SOFA score and age were independent
predictors of hospital survival. There was variability across regions
and income groupings for the critical care management and outcomes of
SARI. Intensive care unit-specific factors, geography and management
features were less reliable than baseline severity for predicting
ultimate outcome. These findings may help in planning future outbreak
severity assessments, but more globally representative data are
required."
}