Comparison of the outcomes of severe influenza A (H1N1) pneumonia in two tertiary referral hospitals in Korea : 2016 versus 2009 = Comparison of the outcomes of severe influenza A (H1N1) pneumonia in two tertiary referral hospitals in Korea : 2016 versus 2009

다국어 초록 (Multilingual Abstract)

Background: In 2016 and 2009, there were pandemics of influenza A (H1N1) in Korea. We aim to investigate whether survival had improved in the setting of recent advances in intensive care unit (ICU) management.
Methods: We conducted a retrospective analysis of patients with severe H1N1 pneumonia. Thirty-four and 28 patients were diagnosed in 2009 and 2016 respectively at two tertiary referral hospitals in Korea.
Results: Of the patients, 28 were treated in 2009 and 34 were treated in 2016. In-hospital mortality was significantly lower in patients of 2016 compared to those of 2009 (18% vs. 44% p=0.028). Multivariable analyses revealed that treatment year and prone position were associated with greater likelihood of survival. Compared to the patients treated in 2009, those treated in 2016 were 3.3 times more likely to survive (adjusted hazard ratio, 3.26; 95% confidence interval, 1.17-9.09). Additionally, patients treated with prone positioning were 3.6 times more likely to survive (adjusted hazard ratio, 3.58; 95% confidence interval, 1.34-9.62).
Conclusion: Treatment outcomes for severe H1N1 pneumonia improved from 2009 to 2016 in two tertiary centers in Korea. Our results suggest that ICU management of viral pneumonia has improved over this period. Active application of prone positioning may be beneficial for patients with severe H1N1 pneumonia.