Ερευνητικό υλικό ΕΚΠΑ

Using research to prepare for outbreaks of severe acute respiratory
infection

Αγγλικά

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.

2019

Mich, Vann
Pho, Yaty
Bory, Sotharith
Vann, Mich
Teav,
Bunlor
Som, Leakhann
Jarrvisalo, Mikko J.
Pulkkinen, Anni
and Kuitunen, Anne
Ala-kokko, Tero
Melto, Sari
Daix, Thomas
and Philippart, Francois
Antoine, Marchalot
Tiercelet, Kelly and
Bruel, Cedric
Nicholas, Sedillot
Siami, Shidasp
Fabienne,
Taimon
Bruyere, Raomi
Forceville, Xavier
Erickson, Simon and
Campbell, Lewis
Sonawane, Ravikiran
Santamaria, John
Kol,
Mark
Awasthi, Shally
Powis, Jeff
Hall, Richard
McCarthy,
Anne E.
Jouvet, Philippe
Opaysky, Mary Anne
Gilfoyle, Elaine
and Farshait, Nataly
Martin, Dori-Ann
Griesdale, Donald and
Katz, Kevin
Ruberto, Aaron J.
Carrier, Francois Martin and
Lamontagne, Francois
Muscedere, John
Rishu, Asgar
Sin, Wai
Ching
Ngai, Wallace Chun Wai
Young, Paul
Forrest, Annette
and Kazemi, Alex
Henderson, Seton
Browne, Troy and
Ganeshalingham, Anusha
McConnochie, Rachael
Cho, Jae Hwa and
Park, Tai Sun
Sim, Yun Su
Chang, Youjin
Lee, Heung Bum and
Park, Seung Yong
Chan, Wai Ming
Lee, Won-Yeon
Wallace, David
J.
Angus, Derek C.
Charles, Anthony G.
van Doom, H. Rogier
and Nguyen Van Kinh
Nguyen Vu Trung
Prin, Meghan and
Twagirumugabe, Theogene
Umuhire, Olivier Felix
Sylvain,
Habarurema
Al Qasim, Eman
Heraud, Jean-Michel
Raberahona,
Mihaja
Rabarison, Joelinotahiana Hasina
Patrigeon, Santiago
Perez
Ramirez-Venegas, Alejandra
Melendez, Javier Araujo and
Guerrero, M. Lourdes
Mambule, Ivan
Ochieng, Otieno George and
Nadjm, Behzad
Li, Iris Wai Sum
Choi, Won-Il
Florence,
Komurian-Pradel
Arabi, Yaseen M.
West, T. Eoin
Riviello,
Elisabeth D.
Parke, Rachael
Djillali, Annane E.
Fowler,
Robert
Murthy, Srinivas
Nichol, Alistair
Cheng, Allen C. and
Semple, Calum
George, Maya
Valkonen, Miia
McArthur, Colin
and Carson, Gail
O'Neill, Genevieve
Cobb, J. Perren
Dunning,
Jake
Chiche, Jean-Daniel
Huh, Jin-Won
Marshall, John and
Rello, Jordi
Guillebaud, Julia
Razanazatovo, Norosoa
Otieno,
Juilett Wambura
Green, Karen
Rowan, Kathy
Baillie, John
Kenneth
Merson, Laura
Hsu, Li Yang
Christian, Michael D. and
Egi, Moritoki
Shindo, Nahoko
Horby, Peter
Pardinaz-Solis,
Raul
Ubiergo, Sebastian Ugarte
Webb, Steve A. R.
Uyeki,
Timothy M.
Gordon, Anthony C.
Paterson, David L.
Everett,
Dean
Giamarellos-Bourboulis, Evangelos J.
Longuere, Kajsa-Stina
and Maslove, David
Ohuma, Eric
Growl, Gloria
PedutemHumber,
Theresa
EllazarHumber, Edward
Bahinskaya, Ilona and
Osbourne-Townsend, Joan
Bentley, Andrew
Goodson, Jennifer and
Welters, Ingeborg
Malik, Nadia
Browne, T. S.
Mahesh, Vinaya
and SPRINT-SARI Investigators

BMJ Global Health

BMJ Publishing Group

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1

https://doi.org/10.1136/bmjgh-2018-001061

10.1136/bmjgh-2018-001061

https://pergamos.lib.uoa.gr/uoa/dl/object/3183560