Search

Your search keyword '"Linko, Rita"' showing total 46 results
Start Over Author "Linko, Rita"
46 results on '"Linko, Rita"'

5. Association between tidal volume size, duration of ventilation, and sedation needs in patients without acute respiratory distress syndrome: an individual patient data meta-analysis

Author

Serpa Neto, Ary, Simonis, Fabienne D., Barbas, Carmen S. V., Biehl, Michelle, Determann, Rogier M., Elmer, Jonathan, Friedman, Gilberto, Gajic, Ognjen, Goldstein, Joshua N., Horn, Janneke, Juffermans, Nicole P., Linko, Rita, de Oliveira, Roselaine Pinheiro, Sundar, Sugantha, Talmor, Daniel, Wolthuis, Esther K., de Abreu, Marcelo Gama, Pelosi, Paolo, and Schultz, Marcus J.

Published
2014
Full Text
View/download PDF

6. SuPAR and PAI-1 in critically ill, mechanically ventilated patients

Author

Jalkanen, Ville, Yang, Runkuan, Linko, Rita, Huhtala, Heini, Okkonen, Marjatta, Varpula, Tero, and Pettilä, Ville

Subjects
Mortality -- United Kingdom -- Taiwan -- Finland, Infection -- Health aspects -- Analysis, Acute respiratory distress syndrome -- Health aspects -- Analysis, Health care industry
Abstract

Purpose SuPAR (soluble urokinase plasminogen activator receptor) and PAI-1 (plasminogen activator inhibitor 1) are active in the coagulation-fibrinolysis pathway. Both have been suggested as biomarkers for disease severity. We evaluated them in prediction of mortality, acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), sepsis and renal replacement therapy (RRT) in operative and non-operative ventilated patients. Methods We conducted a prospective, multicenter, observational study. Blood samples and data of intensive care were collected. Mechanically ventilated patients with baseline suPAR and PAI-1 measurements were included in the analysis, and healthy volunteers were analysed for comparison. Receiver operating characteristics (ROC), logistic regression, likelihood ratios and Kaplan-Meier analysis were performed. Results Baseline suPAR was 11.6 ng/ml (quartiles Q1-Q3, 9.6-14.0), compared to healthy volunteers with suPAR of 0.6 ng/ml (0.5-11.0). PAI-1 concentrations were 2.67 ng/ml (1.53-4.69) and 0.3 ng/ml (0.3-0.4), respectively. ROC analysis for suPAR 90-day mortality areas under receiver operating characteristic curves (AUC) 0.61 (95 % confidence interval (CI): 0.55-0.67), sepsis 0.68 (0.61-0.76), ALI/ARDS 0.64 (0.56-0.73) and RRT 0.65 (0.56-0.73). Patients with the highest quartile of suPAR concentrations had an odds ratio of 2.52 (1.37-4.64, p = 0.003) for 90-day mortality and 3.16 (1.19-8.41, p = 0.02) for ALI/ARDS. In non-operative patients, the AUC's for suPAR were 90-day mortality 0.61 (0.54-0.68), RRT 0.73 (0.64-0.83), sepsis 0.70 (0.60-0.80), ALI/ARDS 0.61 (0.51-0.71). Predictive value of PAI-1 was negligible. Conclusions In non-operative patients, low concentrations of suPAR were predictive for survival and high concentrations for RRT and mortality. SuPAR may be used for screening for patients with potentially good survival. The association with RRT may supply an early warning sign for acute renal failure., Author(s): Ville Jalkanen [sup.1], Runkuan Yang [sup.1], Rita Linko [sup.2], Heini Huhtala [sup.3], Marjatta Okkonen [sup.2], Tero Varpula [sup.2], Ville Pettilä [sup.2] [sup.4], Jyrki Tenhunen [sup.1] [sup.5] Author Affiliations: (1) [...]

Published
2013
Full Text
View/download PDF

7. Acute respiratory failure in intensive care units. FINNALI: a prospective cohort study

Author

Linko, Rita, Okkonen, Marjatta, Pettila, Ville, Perttila, Juha, Parviainen, Ilkka, Ruokonen, Esko, Tenhunen, Jyrki, Ala-Kokko, Tero, and Varpula, Tero

Subjects
Acute respiratory distress syndrome -- Risk factors, Acute respiratory distress syndrome -- Diagnosis, Acute respiratory distress syndrome -- Care and treatment, Acute respiratory distress syndrome -- Research, Intensive care units -- Management, Artificial respiration -- Usage, Company business management, Health care industry
Abstract

Byline: Rita Linko (1), Marjatta Okkonen (1), Ville Pettila (2), Juha Perttila (3), Ilkka Parviainen (4), Esko Ruokonen (4), Jyrki Tenhunen (5), Tero Ala-Kokko (6), Tero Varpula (1) Keywords: Acute respiratory failure; Acute lung injury; Acute respiratory distress syndrome; Mechanical ventilation; Outcome Abstract: Objective To evaluate the incidence, treatment and mortality of acute respiratory failure (ARF) in Finnish intensive care units (ICUs). Study design Prospective multicentre cohort study. Methods All adult patients in 25 ICUs were screened for use of invasive or non-invasive ventilatory support during an 8-week period. Patients needing ventilatory support for more than 6 h were included and defined as ARF patients. Risk factors for ARF and details of prior chronic health status were assessed. Ventilatory and concomitant treatments were evaluated and recorded daily throughout the ICU stay. ICU and 90-day mortalities were assessed. Results A total of 958 (39%) from the 2,473 admitted patients were treated with ventilatory support for more than 6 h. Incidence of ARF, acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) was 149.5, 10.6 and 5.0/100,000 per year, respectively. Ventilatory support was started with non-invasive interfaces in 183 of 958 (19%) patients. Ventilatory modes allowing triggering of spontaneous breaths were preferred (81%). Median tidal volume/predicted body weight was 8.7 (7.6--9.9) ml/kg and plateau pressure 19 (16--23) cm[H.sub.2]O. The 90-day mortality of ARF was 31%. Conclusions While the incidence of ARF requiring ventilatory support is higher, the incidence of ALI and ARDS seems to be lower in Finland than previously reported in other countries. Tidal volumes are higher than recommended in the concept of lung protective strategy. However, restriction of peak airway pressure was used in the majority of ARF patients. Author Affiliation: (1) Intensive Care Units, Department of Anaesthesia and Intensive Care Medicine, Division of Surgery, Helsinki University Hospital, Helsinki, Finland (2) Department of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care Research Center, Monash University, Melbourne, Australia (3) Department of Anesthesia and Intensive Care Medicine, Turku University Hospital, Turku, Finland (4) Division of Intensive Care, Kuopio University Hospital, Kuopio, Finland (5) Department of Intensive Care Medicine, Critical Care Medicine Research Group, Tampere University Hospital, Tampere, Finland (6) Division of Intensive Care, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland Article History: Registration Date: 28/05/2009 Received Date: 14/01/2009 Accepted Date: 07/05/2009 Online Date: 13/06/2009 Article note: This article is discussed in the editorial available at: doi: 10.1007/s00134-009-1518-0. Electronic supplementary material The online version of this article (doi: 10.1007/s00134-009-1519-z) contains supplementary material, which is available to authorized users.

Published
2009

8. Neuraminidase Inhibitors and Hospital Length of Stay: A Meta-analysis of Individual Participant Data to Determine Treatment Effectiveness Among Patients Hospitalized With Nonfatal 2009 Pandemic Influenza A(H1N1) Virus Infection

Author

Venkatesan, Sudhir, Muthuri, Stella G., Al Khuwaitir, Tarig, Bajjou, Tahar, Bassetti, Matteo, Beovic, Bojana, Bonmarin, Isabelle, Booy, Robert, Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Chinbayar, Tserendorj, Cilloniz, Catia, Dubnov-Raz, Gal, Gao, Zhancheng, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath Lorena, Hu, Xiao Yun, Keijzers, Gerben, Khalili, Hossein, Kusznierz, Gabriela, Kuzman, Ilija, Langenegger, Eduard, Leo, Yee-Sin, Libster, Romina P., Linko, Rita, Madanat, Faris, Maltezos, Efstratios, Mamun, Abdullah, Manabe, Toshie, Metan, Gokhan, Mickiene, Auks?, Ozkan, Mehpare, Parekh, Dhruv, Refaey, Samir, Rodriguez, Alejandro H., Sertogullarindan, Bunyamin, Skr?t-Magier?o, Joanna, Somer, Ayper, Talarek, Ewa, Tang, Julian W., Tran, Dat, Vaudry, Wendy, Vidmar, Tjasa, Zarogoulidis, Paul, PRIDE Consortium Investigators, Nguyen-Van-Tam, Jonathan S., Myles, Puja R, Bolton, Kirsty J, Anovadiya, Ashish P, Azziz-Baumgartner, Eduardo, Bertisch, Barbara, Borja-Aburto, Victor H, Denholm, Justin T, Dominguez, Samuel R, Duarte, Pericles A D, Fanella, Sergio, Hoeger, Peter H, Islam, Quazi T, Lankarani, Kamran B, Miki?, Dragan, Mohn, Kristin G I, Oliva, Maria E, Rath, Barbara A, To, Kelvin, Uyeki, Timothy M, and Khandaker, Gulam

Subjects
Infectious Diseases, Immunology and Allergy
Abstract

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. BACKGROUND: The effect of neuraminidase inhibitor (NAI) treatment on length of stay (LoS) in patients hospitalized with influenza is unclear. METHODS: We conducted a one-stage individual participant data (IPD) meta-analysis exploring the association between NAI treatment and LoS in patients hospitalized with 2009 influenza A(H1N1) virus (A[H1N1]pdm09) infection. Using mixed-effects negative binomial regression and adjusting for the propensity to receive NAI, antibiotic, and corticosteroid treatment, we calculated incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Patients with a LoS of

Published
2020

10. Neuraminidase Inhibitors and Hospital Length of Stay: A Meta-analysis of Individual Participant Data to Determine Treatment Effectiveness Among Patients Hospitalized With Nonfatal 2009 Pandemic Influenza A(H1N1) Virus Infection

Author

Venkatesan, Sudhir, Myles, Puja R, Bolton, Kirsty J, Muthuri, Stella G, Al Khuwaitir, Tarig, Anovadiya, Ashish P, Azziz-Baumgartner, Eduardo, Bajjou, Tahar, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H, Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Chinbayar, Tserendorj, Cilloniz, Catia, Denholm, Justin T, Dominguez, Samuel R, Duarte, Pericles A D, Dubnov-Raz, Gal, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath Lorena, Hoeger, Peter H, Hu, Xiao Yun, Islam, Quazi T, Jiménez, Mirela F, Keijzers, Gerben, Khalili, Hossein, Kusznierz, Gabriela, Kuzman, Ilija, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Libster, Romina P, Linko, Rita, Madanat, Faris, Maltezos, Efstratios, Mamun, Abdullah, Manabe, Toshie, Metan, Gokhan, Mickiene, Auksė, Mikić, Dragan, Mohn, Kristin G I, Oliva, Maria E, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Rath, Barbara A, Refaey, Samir, Rodríguez, Alejandro H, Sertogullarindan, Bunyamin, Skręt-Magierło, Joanna, Somer, Ayper, Talarek, Ewa, Tang, Julian W, To, Kelvin, Tran, Dat, Uyeki, Timothy M, Vaudry, Wendy, Vidmar, Tjasa, Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan S, PRIDE Consortium Investigators, Imperial College London, HUS Perioperative, Intensive Care and Pain Medicine, Department of Diagnostics and Therapeutics, Clinicum, Venkatesan S., Myles P.R., Bolton K.J., Muthuri S.G., Al Khuwaitir T., Anovadiya A.P., Azziz-Baumgartner E., Bajjou T., Bassetti M., Beovic B., Bertisch B., Bonmarin I., Booy R., Borja-Aburto V.H., Burgmann H., Cao B., Carratala J., Chinbayar T., Cilloniz C., Denholm J.T., Dominguez S.R., Duarte P.A.D., Dubnov-Raz G., Fanella S., Gao Z., Gerardin P., Giannella M., Gubbels S., Herberg J., Higuera Iglesias A.L., Hoeger P.H., Hu X.Y., Islam Q.T., Jimenez M.F., Keijzers G., Khalili H., Kusznierz G., Kuzman I., Langenegger E., Lankarani K.B., Leo Y.-S., Libster R.P., Linko R., Madanat F., Maltezos E., Mamun A., Manabe T., Metan G., Mickiene A., Mikic D., Mohn K.G.I., Oliva M.E., Ozkan M., Parekh D., Paul M., Rath B.A., Refaey S., Rodriguez A.H., Sertogullarindan B., Skret-Magierlo J., Somer A., Talarek E., Tang J.W., To K., Tran D., Uyeki T.M., Vaudry W., Vidmar T., Zarogoulidis P., and Nguyen-Van-Tam J.S.

Subjects
0301 basic medicine, Male, pandemic influenza, OSELTAMIVIR TREATMENT, IMPACT, Neuraminidase/antagonists & inhibitors, CHILDREN, medicine.disease_cause, 0302 clinical medicine, antivirals, Influenza A Virus, H1N1 Subtype, Adrenal Cortex Hormones, IPD meta-analysi, Influenza A virus, Immunology and Allergy, 030212 general & internal medicine, IPD meta-analysis, Young adult, Enzyme Inhibitors, Child, 11 Medical and Health Sciences, RISK, 11832 Microbiology and virology, Antiviral Agents/therapeutic use, OUTCOMES, COMPLICATIONS, biology, Neuraminidase inhibitor, Enzyme inhibitors, Middle Aged, Antivirals, antiviral, 3. Good health, Anti-Bacterial Agents, Infectious Diseases, Treatment Outcome, Meta-analysis, Cohort, Viruses, Enzyme Inhibitors/pharmacology/therapeutic use, Female, Pandemic influenza, Adult, medicine.medical_specialty, Adolescent, medicine.drug_class, 030106 microbiology, IPD meta-analysis, Neuraminidase inhibitors, antivirals, length of stay, pandemic influenza, Neuraminidase, Adrenal Cortex Hormones/therapeutic use, Microbiology, Antiviral Agents, PRIDE Consortium Investigators, Grip, 03 medical and health sciences, Major Articles and Brief Reports, Young Adult, Pharmacotherapy, Internal medicine, Influenza, Human, medicine, Humans, COHORT, Pandemics, ddc:613, Aged, Neuraminidase inhibitors, business.industry, CLINICAL-FEATURES, ADULTS, 06 Biological Sciences, Influenza, Human/drug therapy/epidemiology, Length of Stay, Confidence interval, Influenza, Editor's Choice, Anti-Bacterial Agents/therapeutic use, Inhibidors enzimàtics, 3121 General medicine, internal medicine and other clinical medicine, biology.protein, business, RESISTANCE
Abstract

Background The effect of neuraminidase inhibitor (NAI) treatment on length of stay (LoS) in patients hospitalized with influenza is unclear. Methods We conducted a one-stage individual participant data (IPD) meta-analysis exploring the association between NAI treatment and LoS in patients hospitalized with 2009 influenza A(H1N1) virus (A[H1N1]pdm09) infection. Using mixed-effects negative binomial regression and adjusting for the propensity to receive NAI, antibiotic, and corticosteroid treatment, we calculated incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Patients with a LoS of, We found that neuraminidase inhibitor (NAI) treatment initiated on hospital admission to patients with clinically diagnosed or laboratory-confirmed A(H1N1)pdm09 virus infection was associated with a reduction in hospital length of stay when compared to later or no NAI treatment.

Published
2018

11. Randomised controlled study comparing general and spinal anaesthesia with and without a tourniquet on the outcomes of total knee arthroplasty: study protocol

Author

Rantasalo, Mikko Tuomas, primary, Palanne, Riku, additional, Juutilainen, Katarina, additional, Kairaluoma, Pekka, additional, Linko, Rita, additional, Reponen, Elina, additional, Helkamaa, Teemu, additional, Vakkuri, Anne, additional, Olkkola, Klaus T, additional, Madanat, Rami, additional, and Skants, Noora Kati Annukka, additional

Published
2018
Full Text
View/download PDF

12. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: an individual participant data meta-analysis

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P., Araújo, Wildo N., Azziz Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M., Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L., Hoeger, Peter H., Hoffmann, Matthias, Xiaoyun, Hu, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo Montero, Elga, Mcgeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skrȩt Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, Nguyen Van Tam, Jonathan S, de Lourdes Aguiar Oliveira, Maria, Al Khuwaitir, Tarig S. A., Al Masri, Malakita, Amin, Robed, Ballester Orcal, Elena, Bao, Jing, Basher, Ariful, Bautista, Edgar, Bertisch, Barbara, Bettinger, Julie, Booy, Robert, Bouza, Emilio, Bozkurt, Ilkay, Burgmann, Heinz, Čeljuska Tošev, Elvira, Chan, Kenny K. C., Chen, Yusheng, Chinbayar, Tserendorj, Cilloniz, Catia, Cox, Rebecca J., Sarrouf, Elena B., Cui, Wei, Dashti Khavidaki, Simin, Bin, Du, El Rhaffouli, Hicham, Escobar, Hernan, Florek Michalska, Agnieszka, Gerrard, John, Gormley, Stuart, Götberg, Sandra, Honarvar, Behnam, Jianming, Hu, Kemen, Christoph, Koay, Evelyn S. C., Kojic, Miroslav, Kudo, Koichiro, Kyaw, Win M., Leibovici, Leonard, Xiao li, Li, Hongru, Li, Libster, Romina, Loh, Tze P., Macbeth, Deborough, Maltezos, Efstratios, Marcone, Debora N., Marczynska, Magdalena, Mastalir, Fabiane P., Mickiene, Aukse, Moghadami, Mohsen, Moriconi, Lilian, Oliva, Maria E., Pečavar, Blaž, Poliquin, Philippe G., Rahman, Mahmudur, Rascon Pacheco, Alberto, Refaey, Samir, Schweiger, Brunhilde, Seale, Anna C., Sertogullarindan, Bunyamin, Smith, Fang G., Somer, Ayper, Souza, Thiago M. L., Stephan, Frank, Tabarsi, Payam, Tripathi, C. B., Viasus, Diego, Qin, Yu, Zhang, Wei, Zuo, Wei, Universitat de Barcelona, Ospedale 'Santa Maria della Misericordia' = University Hospital 'Santa Maria della Misericordia', Institut de Veille Sanitaire (INVS), Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Diseases, Department of physics, engineering physics and astronomy, Queen's University [Kingston, Canada], Peking University People's Hospital, Processus Infectieux en Milieu Insulaire Tropical (PIMIT), Centre National de la Recherche Scientifique (CNRS)-IRD-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de La Réunion (UR), National Perinatal Epidemiology Unit, University of Oxford [Oxford], Instituto Nacional de Enfermedades Respiratorias Dr. Emilio Coni [Santa Fe, Argentina] (INER), State Key Laboratory of Advanced Electromagnetic Engineering and Technology, Huazhong University of Science and Technology [Wuhan] (HUST), People's Hospital of Peking University (PKUPH), Université de La Réunion (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IRD-Centre National de la Recherche Scientifique (CNRS), University of Oxford, Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P., Araújo, Wildo N., Azziz Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlo, Barhoush, Mazen M., Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Fraser, Jame, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L., Hoeger, Peter H., Hoffmann, Matthia, Xiaoyun, Hu, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idri, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee Sin, Linko, Rita, Liu, Pei, Madanat, Fari, Manabe, Toshie, Mayo Montero, Elga, Mcgeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skrȩt Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelie, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, Nguyen Van Tam, Jonathan S, de Lourdes Aguiar Oliveira, Maria, Al Khuwaitir, Tarig S. A., Al Masri, Malakita, Amin, Robed, Ballester Orcal, Elena, Bao, Jing, Basher, Ariful, Bautista, Edgar, Bertisch, Barbara, Bettinger, Julie, Booy, Robert, Bouza, Emilio, Bozkurt, Ilkay, Burgmann, Heinz, Čeljuska Tošev, Elvira, Chan, Kenny K. C., Chen, Yusheng, Chinbayar, Tserendorj, Cilloniz, Catia, Cox, Rebecca J., Sarrouf, Elena B., Cui, Wei, Dashti Khavidaki, Simin, Bin, Du, El Rhaffouli, Hicham, Escobar, Hernan, Florek Michalska, Agnieszka, Gerrard, John, Gormley, Stuart, Götberg, Sandra, Honarvar, Behnam, Jianming, Hu, Kemen, Christoph, Koay, Evelyn S. C., Kojic, Miroslav, Kudo, Koichiro, Kyaw, Win M., Leibovici, Leonard, Xiao li, Li, Hongru, Li, Libster, Romina, Loh, Tze P., Macbeth, Deborough, Maltezos, Efstratio, Marcone, Debora N., Marczynska, Magdalena, Mastalir, Fabiane P., Mickiene, Aukse, Moghadami, Mohsen, Moriconi, Lilian, Oliva, Maria E., Pečavar, Blaž, Poliquin, Philippe G., Rahman, Mahmudur, Rascon Pacheco, Alberto, Refaey, Samir, Schweiger, Brunhilde, Seale, Anna C., Sertogullarindan, Bunyamin, Smith, Fang G., Somer, Ayper, Souza, Thiago M. L., Stephan, Frank, Tabarsi, Payam, Tripathi, C. B., Viasus, Diego, Qin, Yu, Zhang, Wei, Zuo, Wei, Pediatric surgery, and ICaR - Circulation and metabolism

Subjects
Hospitalisation, Individual participant data meta-analyses, Influenza-related pneumonia, Neuraminidase inhibitors, Adolescent, Adrenal Cortex Hormones, Adult, Anti-Bacterial Agents, Antiviral Agents, Child, Child, Preschool, Enzyme Inhibitors, Female, Humans, Influenza, Human, Male, Middle Aged, Neuraminidase, Odds Ratio, Pneumonia, Viral, Treatment Outcome, Young Adult, Influenza A Virus, H1N1 Subtype, 0301 basic medicine, Epidemiology, [SDV]Life Sciences [q-bio], viruses, Meta-análises de dados de participantes individuais, Antibiotics, Pneumònia, Adrenal Cortex Hormone, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit, influenza-related pneumonia, neuraminidase inhibitors, 0302 clinical medicine, individual participant data meta‐analyses, Influenza A Virus, Enzyme Inhibitor, 030212 general & internal medicine, Viral, Incidence (epidemiology), Inibidores da neuraminidase, virus diseases, 3. Good health, Hospitalization, Infectious Diseases, Meta-analysis, Original Article, Individual participant data meta-analyse, Public Health, Human, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Antagonists & inhibitors, medicine.drug_class, influenza-related pneumonia, 030106 microbiology, influenza‐related pneumonia, Neuraminidase inhibitor, Ingressos i altes en els hospitals, Public Health, Environmental and Occupational Health, 03 medical and health sciences, Open Access, Pneumonia relacionada à gripe, Pharmacotherapy, Internal medicine, Anti-Bacterial Agent, medicine, H1N1 Subtype, Preschool, Antiviral Agent, Hospitalização, Hospital admission and discharge, business.industry, Environmental and Occupational Health, individual participant data meta-analyses, Original Articles, Odds ratio, Pneumonia, medicine.disease, Influenza, respiratory tract diseases, El Niño, Immunology, business
Abstract

Stella G. Muthuri,1 Sudhir Venkatesan,1 Puja R. Myles,1 Jo Leonardi-Bee,1 Wei Shen Lim,2 Abdullah Al Mamun,3 Ashish P. Anovadiya,4 Wildo N. Ara ujo,5 Eduardo Azziz-Baumgartner,6 Clarisa B aez,7 Carlos Bantar,8 Mazen M. Barhoush,9 Matteo Bassetti,10 Bojana Beovic,11 Roland Bingisser,12 Isabelle Bonmarin,13 Victor H. Borja-Aburto,14 Bin Cao,15 Jordi Carratala,16 Mar ıa R. Cuezzo,17 Justin T. Denholm,18 Samuel R. Dominguez,19 Pericles A. D. Duarte,20 Gal Dubnov-Raz,21 Marcela Echavarria,22 Sergio Fanella,23 James Fraser,24 Zhancheng Gao,25 Patrick G erardin,26,27,28,29 Maddalena Giannella,30 Sophie Gubbels,31 Jethro Herberg,32 Anjarath L. Higuera Iglesias,33 Peter H. Hoeger,34 Matthias Hoffmann,35 Xiaoyun Hu,36 Quazi T. Islam,37 Mirela F. Jim enez,38 Amr Kandeel,39 Gerben Keijzers,40 Hossein Khalili,41 Gulam Khandaker,42 Marian Knight,43 Gabriela Kusznierz,44 Ilija Kuzman,45 Arthur M. C. Kwan,46 Idriss Lahlou Amine,47 Eduard Langenegger,48 Kamran B. Lankarani,49 Yee-Sin Leo,50 Rita Linko,51 Pei Liu,52 Faris Madanat,53 Toshie Manabe,54 Elga Mayo-Montero,55 Allison McGeer,56 Ziad A. Memish,57,58 Gokhan Metan,59 Dragan Miki c,60 Kristin G. I. Mohn,61,62 Ahmadreza Moradi,63,64 Pagbajabyn Nymadawa,65 Bulent Ozbay,66 Mehpare Ozkan,67 Dhruv Parekh,68 Mical Paul,69 Wolfgang Poeppl,70 Fernando P. Polack,71,72 Barbara A. Rath,73 Alejandro H. Rodr ıguez,74 Marilda M. Siqueira,75 Joanna Skre zt-Magierło,76 Ewa Talarek,77 Julian W. Tang,78,79,80 Antoni Torres,81 Selda H. T€ or€un,82 Dat Tran,83 Timothy M. Uyeki,84 Annelies van Zwol,85 Wendy Vaudry,86 Daiva Velyvyte,87 Tjasa Vidmar,88 Paul Zarogoulidis,89 PRIDE Consortium Investigators* Jonathan S. Nguyen-Van-Tam1 1Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK. 2Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK. 3International Centre for Diarrhoeal Diseases, Research Bangladesh (ICDDRB), Dhaka, Bangladesh. 4Department of Pharmacology, Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar, Gujarat, India. 5University of Bras ılia, Bras ılia, DF, Brazil. 6Centers for Disease Control and Prevention, Atlanta, GA, USA. 7Ministerio de Salud de la Provincia de Buenos Aires, Buenos Aires, Argentina. 8Department of Infection Control, Hospital San Mart ın de Paran a, Entre R ıos, Argentina. 9Department of Medicine, King Saud Medical City, Riyadh, Saudi Arabia. 10Santa Maria Misericordia Hospital, Udine, Italy. 11Department of Infectious Diseases, University Medical Centre, Ljubljana, Slovenia. 12Department of Emergency Medicine, University Hospital Basel, Basel, Switzerland. 13Institut de Veille Sanitaire, Saint-Maurice, France. 14Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico. 15Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China. 16Department of Infectious Diseases, Hospital Universitari de Bellvitge, Bellvitge Institute for Biomedical Research, L’Hospitalet de Llobregat, Red Espa~nola de Investigaci on en Patolog ıa Infecciosa, University of Barcelona, Barcelona, Spain. 17Ministerio de Salud de Tucum an, Tucum an, Argentina. 18Victorian Infectious Diseases Service and Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, Parkville, Vic., Australia. 19Department of Pediatric Infectious Diseases, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA. 20Universidade Estadual do Oeste do Parana ´, UNIOESTE, Cascavel, PR, Brazil. 21The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel-Hashomer, Israel. 22Clinical Virology Laboratory, CEMIC University Hospital, Buenos Aires, Argentina. 23Section of Pediatric Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada. 24Paediatric Intensive Care Unit, Bristol Children’s Hospital, Bristol, UK. 25Department of Respiratory & Critical Care Medicine, Peking University People’s Hospital, Beijing, China. 26NICU/PICU, PFME, CHU Saint Pierre, Saint Pierre, La R eunion, France. 27CIC 1410 (CHU/Inserm/University of La Re ´union/URML-OI), CHU Saint Pierre, Saint Pierre, La Réunion, France. 28UMR PIMIT (CHU/Inserm/University of La Re ´union/IRD/CNRS), CYROI, Saint Denis – Reunion Island, Saint Denis, France. 29NICU/PICU CHU of La Re ´union, Groupe Hospitalier Sud Re ´union, Saint Pierre, La Re ´union, France. 30Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Maran ˜o ´n, Madrid, Spain. 31Department of Infectious Disease Epidemiology, Sector for National Health Documentation and Research, Statens Serum Institut, Copenhagen, Denmark. 32Section of Paediatrics, Division of Infectious Disease, Imperial College, London, UK. 33Epidemiology Research Unit, Instituto Nacional de Enfermedades Respiratorias, Ismael Cosı ´o Villegas, Mexico City, Mexico. 34Cath. Children’s Hospital Wilhelmstift, Hamburg, Germany. 35Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital St. Gallen, St. Gallen, Switzerland. 36Peking Union Medical College Hospital, Beijing, China. 37Dhaka Medical College Hospital, Dhaka, Bangladesh. 38Departamento de Ginecologia e Obstetrı ´cia – UFCSPA, Preceptora da Reside ˆncia Me ´dica do Hospital Fe ˆmina, Porto Alegre, Brazil. 39Ministry of Health in Egypt, Cairo, Egypt. 40Gold Coast Hospital, Gold Coast, Qld, Australia. 41Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. 42National Centre for Immunisation Research and Surveillance (NCIRS), The Children’s Hospital at Westmead, University of Sydney, Sydney, NSW, Australia. 43National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. 44National Institute of Respiratory Diseases ‘Emilio Coni’ ANLIS “C. Malbran”, Santa Fe, Argentina. 45School of Medicine, University Hospital for Infectious Diseases, University of Zagreb, Zagreb, Croatia. 46Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong. 47Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Biosafety Level 3 and Research Laboratory, University Mohammed V-Souissi, Rabat, Morocco. 48Department of Obstetrics and Gynaecology, Stellenbosch University and Tygerberg, Stellenbosch, South Africa. 49Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. 50Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore. 51Helsinki University Hospital, Helsinki, Finland. 52Department of Infectious Diseases, The First Affiliated Hospital, China Medical University, Shenyang, China. 53Department of Pediatrics, King Hussein Cancer Center, Amman, Jordan. 54Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan. 55Instituto de Medicina Preventiva de la Defensa, Capitan Medico Ramon y Cajal (IMPDEF), Ministerio de Defensa, Madrid, Spain. 56Toronto Invasive Bacterial Diseases Network, University of Toronto, Toronto, ON, Canada. 57Ministry of Health, Riyadh, Saudi Arabia. 58College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. 59Department of Infectious Diseases and Clinical Microbiology, Erciyes University Faculty of Medicine, Kayseri, Turkey. 60Military Medical Academy, Clinic for Infectious and Tropical Diseases, Belgrade, Serbia. 61Section for Infectious Diseases, Medical Department, and Department of Research and Development, Haukeland University Hospital, Bergen, Norway. 62Department of Clinical Science, The Influenza Centre, University of Bergen, Bergen, Norway. 63The Division of Ocular Immunology, Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 64National Research Institute for Tuberculosis and Lung Disease, Massih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 65National Influenza Center, National Center of Communicable Diseases, Ministry of Health, Ulaanbaatar, Mongolia. 66Department of Pulmonary and Critical Care, Yuzuncu Yil University Medical Faculty, Van, Turkey. 67Clinic of Pediatric Neurology, Dr. Sami Ulus Research and Training Hospital of Women’s and Children’s Health and Diseases, Ankara, Turkey. 68Critical Care and Pain Perioperative, Critical Care and Trauma Trials Group, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK. 69Division of Infectious Diseases, Rambam Health Care Campus, Haifa, Israel. 70Medical University of Vienna, Vienna, Austria. 71Department of Pediatrics, Vanderbilt Vaccine Center, Vanderbilt University, Nashville, TN, USA. 72Fundacion INFANT, Buenos Aires, Argentina. 73Division of Pneumonology-Immunology, Department of Pediatrics, Charite ´ University Medical Center, Berlin, Germany. 74Critical Care Department, Hospital Joan XXIII, IISPV, URV, CIBERES, Tarragona, Spain. 75Laboratory of Respiratory Viruses, Oswaldo Cruz Institute/Fiocruz, Rio de Janeiro, Brazil. 76Uniwersytet Rzeszowski, Rzeszo ´w, Poland. 77Department of Children’s Infectious Diseases, Medical University of Warsaw, Warsaw, Poland. 78Division of Microbiology/Molecular Diagnostic Centre, Department of Laboratory Medicine, National University Hospital, Singapore, Singapore. 79Alberta Provincial Laboratory for Public Health, University of Alberta Hospital, Edmonton, Canada. 80Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada. 81Hospital Clinic, University of Barcelona, IDIBAPS, CIBERES, Barcelona, Spain. 82Department of Pediatric Infectious Diseases, Istanbul Medical Faculty, Istanbul, Turkey. 83Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Canada. 84Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. 85Department of Pediatric Intensive Care, VU University Medical Center, Amsterdam, The Netherlands. 86Division of Infectious Diseases, Department of Pediatrics, Stollery Children’s Hospital, University of Alberta, Edmonton, AB, Canada. 87Lithuanian University of Health Sciences, Kaunas, Lithuania. 88General Hospital, Slovenj Gradec, Slovenia. 89Unit of Infectious Diseases, University General Hospital of Alexandroupolis, Democritus University Thrace, Dragana, Greece. Correspondence: Jonathan S. Nguyen-Van-Tam, University of Nottingham, City Hospital, DM, Room A28b, Clinical Sciences Building, Nottingham NG5 1PB, UK. E-mail: jvt@nottingham.ac.uk *List of PRIDE Consortium Investigators are in Appendix 1. For affiliations, please see Table S1. Múltipla - ver em notas Background The impact of neuraminidase inhibitors (NAIs) on influenza-related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1) pdm09 virus infection. Methods A worldwide meta-analysis of individual participant data from 20 634 hospitalised patients with laboratory-confirmed A (H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. Results Of 20 634 included participants, 5978 (29 0%) had IRP; conversely, 3349 (16 2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0 83 (95% CI 0 64–1 06; P = 0 136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0 72 (0 44–1 17; P = 0 180)] or likelihood of requiring ventilatory support [adj. OR = 1 17 (0 71– 1 92; P = 0 537)], but early treatment versus later significantly reduced mortality [adj. OR = 0 70 (0 55–0 88; P = 0 003)] and likelihood of requiring ventilatory support [adj. OR = 0 68 (0 54– 0 85; P = 0 001)]. Conclusions Early NAI treatment of patients hospitalised with A (H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.

Published
2016

13. Intravenous patient-controlled analgesia vs nurse administered oral oxycodone after total knee arthroplasty: a retrospective cohort study.

Author

Lahtinen, Katarina, Reponen, Elina, Vakkuri, Anne, Palanne, Riku, Rantasalo, Mikko, Linko, Rita, Madanat, Rami, and Skants, Noora

Abstract

Objectives: Severe post-operative pain is common after total knee arthroplasty. Patient-controlled analgesia is an alternative method of pain management, whereby a patient administers his or her own pain medication. Patients seem to prefer this method over nurse-administered analgesia. However, it remains unclear whether patients using patient-controlled analgesia devices use higher or lower doses of opioids compared to patients treated with oral opioids. Methods: This retrospective study examined 164 patients undergoing total knee arthroplasty. Post-operatively, 82 patients received oxycodone via intravenous patient-controlled analgesia devices, while the pain medication for 82 patients in the control group was administered by nurses. The main outcome measure was the consumption of intravenous opioid equivalents within 24 h after surgery. Secondary outcome measures were the use of anti-emetic drugs and the length of stay. Furthermore, we evaluated opioid-related adverse event reports. Results: The consumption of opioids during the first 24 h after surgery and the use of anti-emetic drugs were similar in both groups. The median opioid dose of intravenous morphine equivalents was 41.1 mg (interquartile range (IQR): 29.5–69.1 mg) in the patient-controlled analgesia group and 40.5 mg (IQR: 32.4–48.6 mg) in the control group, respectively. The median length of stay was 2 days (IQR: 2–3 days) in the patient-controlled analgesia group and 3 days (IQR: 2–3 days) in the control group (p=0.02). The use of anti-emetic drugs was similar in both groups. Conclusions: The administration of oxycodone via intravenous patient-controlled analgesia devices does not lead to increased opioid or anti-emetic consumptions compared to nurse-administered pain medication after total knee arthroplasty. Patient-controlled analgesia might lead to shortened length of stay. [ABSTRACT FROM AUTHOR]

Published
2021
Full Text
View/download PDF

14. Circulating chromogranin B levels in patients with acute respiratory failure : data from the FINNALI Study

Author

Myhre, Peder Langeland, Stridsberg, Mats, Linko, Rita, Okkonen, Marjatta, Nygård, Ståle, Christensen, Geir, Pettilä, Ville, Omland, Torbjørn, Røsjø, Helge, Myhre, Peder Langeland, Stridsberg, Mats, Linko, Rita, Okkonen, Marjatta, Nygård, Ståle, Christensen, Geir, Pettilä, Ville, Omland, Torbjørn, and Røsjø, Helge

Abstract

PURPOSE: Circulating chromogranin B (CgB) levels are increased in situations characterized by systemic and myocardial stress, but whether CgB provides prognostic information in patients with acute respiratory failure (ARF) is unknown. METHODS: We included 584 patients with ARF, defined as ventilatory support >6 h, and with blood samples available on Intensive Care Unit (ICU) admission and day 3 (n = 479). CgB levels were measured by radioimmunoassay and follow-up was 90 days. RESULTS: One-hundred-sixty-nine patients (29%) died during follow-up. Admission CgB levels separated non-survivors from survivors: median 1234 (Q1-3 989-1742) vs. 917 (753-1224) pmol/L, respectively, p < 0.001. CgB levels on ICU admission (logarithmically transformed) were associated with time to death after adjustment for established risk indices available on ICU admission, including N-terminal pro-B-type natriuretic levels: HR 2.62 (95%C.I. 1.82-3.77), p < 0.001. Admission CgB levels also improved prognostication on top of SOFA and SAPS II scores as assessed by Cox regression analyses and the category-free net reclassification index. The area under the curve (AUC) for admission CgB levels to separate survivors and non-survivors was 0.72 (95%CI 0.67-0.76), while the AUC on day 3 was 0.60 (0.54-0.66). CONCLUSIONS: CgB levels measured on ICU admission provided additional prognostic information to established risk indices in ARF patients.

Published
2017
Full Text
View/download PDF

15. Prognostic Value of Secretoneurin in Patients with Acute Respiratory Failure: Data from the FINNALI Study

Author

Christensen, Geir, Pettilä, Ville Yrjö Olavi, Linko, Rita, Okkonen, Marjatta, Omland, Torbjørn, Nygård, Ståle, Røsjø, Helge, Ottesen, Anett H, Myhre, Peder L, and Stridsberg, Mats

Subjects
610 Medicine & health
Abstract

BACKGROUND We examined whether secretoneurin (SN), a biomarker associated with cardiomyocyte Ca(2+) handling, provides prognostic information in patients with acute respiratory failure (ARF). METHODS We included 490 patients with ARF, defined as ventilatory support >6 h, with blood samples available on admission to the intensive care unit (ICU). SN concentrations were measured by RIA. RESULTS A total of 209 patients (43%) were hospitalized with cardiovascular (CV)-related ARF, and 90-day mortality rates were comparable between CV- and non-CV-related ARF (n = 281): 31% vs 24%, P = 0.11. Admission SN concentrations were higher in nonsurvivors than in survivors in both CV-related (median 148 [quartile 1-3, 117-203] vs 108 [87-143] pmol/L, P < 0.001) and non-CV-related ARF (139 [115-184] vs 113 [91-139] pmol/L, P < 0.001). In patients with CV-related ARF, SN concentrations on ICU admission were associated with 90-day mortality [odds ratio (OR) 1.97 (95% CI, 1.04-3.73, P = 0.04)] after adjusting for established risk indices, including N-terminal-pro-B-type natriuretic peptide (NT-proBNP) concentrations. SN also improved patient classification in CV-related ARF as assessed by the net reclassification index: 0.32 (95% CI, 0.04-0.59), P = 0.03. The area under the curve (AUC) of SN to predict mortality in patients with CV-related ARF was 0.72 (95% CI, 0.65-0.79), and the AUC of NT-proBNP was 0.64 (0.56-0.73). In contrast, SN concentrations on ICU admission did not provide incremental prognostic value to established risk indices in patients with non-CV-related ARF, and the AUC was 0.67 (0.60-0.75). CONCLUSIONS SN concentrations measured on ICU admission provided incremental prognostic information to established risk indices in patients with CV-related ARF, but not in patients with non-CV-related ARF.

Published
2016
Full Text
View/download PDF

16. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: an IPD meta-analysis

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Mamun, Abdullah Al, Anovadiya, Ashish P., Araújo, Wildo N., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M., Bassetti, Matteo, Beović, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja-Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L., Hoeger, Peter H., Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt-Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan S.

Abstract

BACKGROUND: The impact of neuraminidase inhibitors (NAIs) on Influenza-related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. ----- METHODS: A worldwide meta-analysis of individual participant data (IPD) from 20,634 hospitalised patients with laboratory confirmed A(H1N1)pdm09 (n=20,021) or clinically diagnosed (n=613) 'pandemic influenza'. The primary outcome was radiologically confirmed influenza-related pneumonia (IRP). Odds ratios (OR) were estimated using generalized linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. ----- RESULTS: Among 20,634 included participants, 5,978 (29.0%) had IRP; conversely, 3,349 (16.2%) had confirmed absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0.83 (95%CI 0.64 - 1.06; p=0.136)]. Among the 5,978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR=0.72 (0.44-1.17; p=0.180)] or likelihood of requiring ventilatory support [adj. OR=1.17 (0.71-1.92; p=0.537)]; but early treatment versus later significantly reduced mortality [adj. OR=0.70 (0.55-0.88; p=0.003)] and likelihood of requiring ventilatory support [adj. OR=0.68 (0.54-0.85; p=0.001)]. ----- CONCLUSIONS: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.

Published
2015

17. Prognostic Value of Secretoneurin in Patients with Acute Respiratory Failure : Data from the FINNALI Study

Author

Myhre, Peder L., Ottesen, Anett H., Okkonen, Marjatta, Linko, Rita, Stridsberg, Mats, Nygård, Ståle, Christensen, Geir, Pettilä, Ville, Omland, Torbjörn, Rösjö, Helge, Myhre, Peder L., Ottesen, Anett H., Okkonen, Marjatta, Linko, Rita, Stridsberg, Mats, Nygård, Ståle, Christensen, Geir, Pettilä, Ville, Omland, Torbjörn, and Rösjö, Helge

Abstract

BACKGROUND: We examined whether secretoneurin (SN), a biomarker associated with cardiomyocyte Ca2+ handling, provides prognostic information in patients with acute respiratory failure (ARF). METHODS: We included 490 patients with ARF, defined as ventilatory support >6 h, with blood samples available on admission to the intensive care unit (ICU). SN concentrations were measured by RIA. RESULTS: A total of 209 patients (43%) were hospitalized with cardiovascular (CV)-related ARF, and 90-day mortality rates were comparable between CV- and non CV-related ARF (n = 281): 31% vs 24%, P = 0.11. Admission SN concentrations were higher in nonsurvivors than in survivors in both CV -related (median 148 [quartile 1-3, 117-203] vs 108 [87-143] pmol/L, P < 0.001) and non CV-related ARF (139 [115-184] vs 113 [91-139] pmol/L, P < 0.001). In patients with CV -related ARF, SN concentrations on ICU admission were associated with 90-day mortality [odds ratio (OR) 1.97 (95% CI, 1.04-3.73, P = 0.04)] after adjusting for established risk indices, including N-terminal-pro-B-type natriuretic peptide (NT-proBNP) concentrations. SN also improved patient classification in CV -related ARF as assessed by the net reclassification index: 0.32 (95% CI, 0.04-0.59), P = 0.03. The area under the curve (AUC) of SN to predict mortality in patients with CV -related ARF was 0.72 (95% CI, 0.65-0.79), and the AUC of NT-proBNP was 0.64 (0.56-0.73). In contrast, SN concentrations on ICU admission did not provide incremental prognostic value to established risk indices in patients with non CV-related ARF, and the AUC was 0.67 (0.60-0.75). CONCLUSIONS: SN concentrations measured on ICU admission provided incremental prognostic information to established risk indices in patients with CV -related ARF, but not in patients with non CV-related ARF.

Published
2016
Full Text
View/download PDF

18. Prognostic Value of Secretoneurin in Critically III Patients With Infections

Author

Røsjø, Helge, Stridsberg, Mats, Ottesen, Anett H., Nygård, Ståle, Christensen, Geir, Pettilä, Ville, Linko, Rita, Karlsson, Sari, Varpula, Tero, Ruokonen, Esko, Omland, Torbjorn, Røsjø, Helge, Stridsberg, Mats, Ottesen, Anett H., Nygård, Ståle, Christensen, Geir, Pettilä, Ville, Linko, Rita, Karlsson, Sari, Varpula, Tero, Ruokonen, Esko, and Omland, Torbjorn

Abstract

Objectives : Secretoneurin is produced in neuroendocrine cells, and the myocardium and circulating secretoneurin levels provide incremental prognostic information to established risk indices in cardiovascular disease. As myocardial dysfunction contributes to poor outcome in critically ill patients, we wanted to assess the prognostic value of secretoneurin in two cohorts of critically ill patients with infections. Design: Two prospective, observational studies. Setting: Twenty-four and twenty-five ICUs in Finland. Patients: A total of 232 patients with severe sepsis (cohort #1) and 94 patients with infections and respiratory failure (cohort #2). Interventions: None. Measurements and Main Results: We measured secretoneurin levels by radioimmunoassay in samples obtained early after ICU admission and compared secretoneurin with other risk indices. In patients with severe sepsis, admission secretoneurin levels (logarithmically transformed) were associated with hospital mortality (odds ratio, 3.17 [95% CI, 1.12-9.00]; p = 0.030) and shock during the hospitalization (odds ratio, 2.17 [1.06-4.46]; p = 0.034) in analyses that adjusted for other risk factors available on ICU admission. Adding secretoneurin levels to age, which was also associated with hospital mortality in the multivariate model, improved the risk prediction as assessed by the category-free net reclassification index: 0.35 (95% CI, 0.06-0.64) (p = 0.02). In contrast, N-terminal pro B-type natriuretic peptide levels were not associated with mortality in the multivariate model that included secretoneurin measurements, and N-terminal pro B-type natriuretic peptide did not improve patient classification on top of age. Secretoneurin levels were also associated with hospital mortality after adjusting for other risk factors and improved patient classification in cohort #2. In both cohorts, the optimal cutoff for secretoneurin levels at ICU admission to predict hospital mortality was approximate to 175 pmol/L, and hi

Published
2016
Full Text
View/download PDF

19. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Miki?, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skr?t-Magier?o, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan

Abstract

Neuraminidase inhibitors were widely used during the 2009/10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection. We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling. We included data for 29?234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70?0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41?0·56; p

Published
2014

20. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: an individual participant data meta-analysis

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S. A., Al Mamun, Adbullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. H., Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Amine, Idriss L., Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Auksė, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K. W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T. C., Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan S., Département des maladies infectieuses, Institut de Veille Sanitaire (INVS), Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Diseases, Peking University People's Hospital, Réanimation médicale néonatale et pédiatrique, CHR la Reunion site Sud, CIC régional épidémiologie clinique/essais cliniques - Ile de la Réunion (CIC-EC), Institut National de la Santé et de la Recherche Médicale (INSERM), Processus Infectieux en Milieu Insulaire Tropical (PIMIT), Centre National de la Recherche Scientifique (CNRS)-IRD-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de La Réunion (UR), Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), National Perinatal Epidemiology Unit, University of Oxford [Oxford], People's Hospital of Peking University (PKUPH), Université de La Réunion (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IRD-Centre National de la Recherche Scientifique (CNRS), and University of Oxford

Subjects
[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology
Abstract

International audience; Background: Neuraminidase inhibitors were widely used during the 2009–10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection.Methods: We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling.Findings: We included data for 29 234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70–0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41–0·56; p

Published
2014

23. Incidence, treatment and outcome of critically ill patients with acute respiratory failure

Author

Linko, Rita, University of Helsinki, Faculty of Medicine, Institute of Clinical Medicine, Helsingin yliopisto, lääketieteellinen tiedekunta, kliininen laitos, Helsingfors universitet, medicinska fakulteten, institutionen för klinisk medicin, and Räsänen, Jukka

Subjects
lääketiede
Abstract

Acute respiratory failure (ARF) is the most common organ failure in critically ill patients. Up to 74% of patients in intensive care units (ICUs) need some kind of ventilatory support. Additional organ failures are associated with higher mortality. High morbidity and mortality together with increased cost of mechanical ventilation, necessitates assessment of long-term outcome, and an analysis of cost-effectiveness. The aim of this study was to evaluate the incidence, treatment, and outcome of patients suffering from overall ARF, and a subset suffering from pandemic influenza A(H1N1) virus infection, in Finnish ICUs. The predictive value of serum zinc in organ failure and mortality was studied in ARF patients. One-year outcome for ARF was assessed. Health related quality of life (HRQOL), quality-adjusted life years (QALYs) for one-year survivors, and cost for one QALY, was estimated. A total of 958 patients from 25 Finnish ICUs needed ventilatory support for more than 6 hours during an 8-week period in 2007. Serum zinc level was assessd in 551 patients. A total of 132 H1N1 patients were assessed for incidence, treatment, and short-term outcome during an outbreak between 11 October and 31 December 2009. The incidence of ARF, and acute respiratory distress syndrome (ARDS) in the adult population were 149.5/100,000 and 5.0/100,000 per year, respectively. Median tidal volume per predicted body weight was 8.7 ml/kg and airway pressure was 19 cmH2O. The 90-day mortality of ARF was 31%, and one-year mortality was 35%. The incidence of H1N1 was 24.7 per million inhabitants. Corticosteroids were used frequently and their use was not associated with mortality in these patients. Rescue therapies, except prone positioning, were rarely used. Hospital mortality of H1N1 patients was 8%. The level of serum zinc decreased with increased severity of cardiovascular organ failure, but was not associated with 30-day mortality. HRQOL at one year after ARF was lower than population values of similar age and gender. The mean estimated cost for a hospital survivor was 20,739. The mean predicted lifetime QALYs were 11.3, and cost for one QALY for all ARF patients was 1,391. This study showed that the incidence of ARF was higher, while the incidence of ARDS was lower in Finland than reported from other countries. Tidal volumes were higher than recommended in the concept of lung protective ventilation. The short- and long term mortality was low. The incidence of H1N1 was similar to that previously reported. Corticosteroid treatment was frequently used. Hospital mortality of H1N1 was 8%. Serum zinc level was not useful in predicting 30-day mortality. Cost per hospital survivor, and lifetime cost-utility was reasonable. Äkillinen hengitysvajaus on yleisin teho-osastolla hoidettava elinhäiriö. Tehopotilaista jopa 74% tarvitsee jonkinlaista hengityslaitehoitoa. Hengitysvajauspotilaiden kuolleisuus kasvaa muiden elinhäiriöiden lisääntyessä. Pitkäaikaisseuranta ja kustannusvaikuttavuuden arviointi on suositeltavaa, koska hengitysvajauksen hoito on kallista ja sairastavuus sekä kuolleisuus korkeita. Tämän tutkimuksen tarkoituksena oli selvittää yleisesti äkillisen hengitysvajauksen esiintyvyys, hoito ja ennuste Suomen teho-osastoilla sekä arvioida tehohoitoon joutuneiden pandeemista influenssa A(H1N1) infektiota sairastavien potilaiden määrä, hoito ja ennuste. Seerumin sinkin yhteys elinhäiriöihin ja kuolleisuuteen tutkittiin hengitysvajauspotilailla. Hengitysvajauspotilaiden yhden vuoden kuolleisuus ja terveyteen liittyvä elämänlaatu selvitettiin, sekä arvioitiin saavutettujen laatupainotettujen elinvuosien määrä ja yhden vuoden hinta. Äkillisen hengitysvajauksen vuoksi yli 6 tuntia hengityslaitehoitoa tarvitsevia potilaita 8 viikon tutkimusjakson aikana vuonna 2007 oli 958. Näistä potilaista seerumin sinkki määritettiin 551 potilaalta. Influenssapandemian aikana 11.10-31.12.2009 hoidettiin teho-osastoilla 132 potilasta, joilla oli varmistettu H1N1 infektio. Äkillisen hengitysvajauksen esiintyvyys oli aiempia raportteja korkeampi, mutta äkillisen hengitysvaikeusoireyhtymän esiintyvyys oli matalampi. Hengityslaitehoidossa kertatilavuuksien osalta ei noudatettu keuhkoja suojaavan ventilaation suositusta. Kuolleisuus 90 päivän kohdalla oli 31% ja vuoden kohdalla 35%. Teho-osastoilla hoidettujen H1N1-potilaiden esiintyvyys vastasi aiemmin todettua. Monet potilaat saivat kortikosteroidilääkitystä, eikä sillä ollut vaikutusta kuolleisuuteen. Kehonulkoisen happeutuslaitteiston ja muiden erityishoitojen käyttö vatsamakuutusta lukuun ottamatta oli harvinaista. H1N1 potilaiden sairaalakuolleisuus oli 8%. Seerumin sinkillä ei ollut ennustearvoa hengitysvajauspotilailla. Hengitysvajauspotilaiden terveyteen liittyvä elämänlaatu vuoden jälkeen sairastumisesta oli huonompi kuin samaa ikää ja sukupuolta olevien viitearvot. Äkillisen hengitysvajauksen tehohoitoa voidaan pitää kustannustehokkaana, sillä sairaalasta selviytyneen potilaan arvioitu keskimääräinen kustannus oli 20,739 , laatupainotettujen elinvuosien määrä 11.3 ja kustannus yhtä laatupainotettua vuotta kohti 1,391 .

Published
2012

24. Lung-Protective Ventilation With Low Tidal Volumes and the Occurrence of Pulmonary Complications in Patients Without Acute Respiratory Distress Syndrome

Author

Neto, Ary Serpa, primary, Simonis, Fabienne D., additional, Barbas, Carmen S. V., additional, Biehl, Michelle, additional, Determann, Rogier M., additional, Elmer, Jonathan, additional, Friedman, Gilberto, additional, Gajic, Ognjen, additional, Goldstein, Joshua N., additional, Linko, Rita, additional, Pinheiro de Oliveira, Roselaine, additional, Sundar, Sugantha, additional, Talmor, Daniel, additional, Wolthuis, Esther K., additional, Gama de Abreu, Marcelo, additional, Pelosi, Paolo, additional, and Schultz, Marcus J., additional

Published
2015
Full Text
View/download PDF

26. Serum activin A and B, and follistatin in critically ill patients with influenza A(H1N1) infection

Author

University of Helsinki, Faculty of Medicine (-2009), University of Helsinki, Clinicum, Linko, Rita Teresa, Hedger, Mark P., Pettila, Ville, Ruokonen, Esko, Ala-Kokko, Tero, Ludlow, Helen, de Kretser, David M., University of Helsinki, Faculty of Medicine (-2009), University of Helsinki, Clinicum, Linko, Rita Teresa, Hedger, Mark P., Pettila, Ville, Ruokonen, Esko, Ala-Kokko, Tero, Ludlow, Helen, and de Kretser, David M.

Published
2014

32. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09‐related pneumonia: an individual participant data meta‐analysis

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan S., Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan S.

Abstract

BACKGROUND: The impact of neuraminidase inhibitors (NAIs) on influenza‐related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. METHODS: A worldwide meta‐analysis of individual participant data from 20 634 hospitalised patients with laboratory‐confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. RESULTS: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. CONCLUSIONS: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.

Full Text
View/download PDF

33. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan, Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan

Abstract

Neuraminidase inhibitors were widely used during the 2009/10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection. We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling. We included data for 29?234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70?0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41?0·56; p<0·0001). Early treatment versus no treatment was also associated with a reduction in mortality (adjusted OR 0·50; 95% CI 0·37?0·67; p<0·0001). These associat

Full Text
View/download PDF

34. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09‐related pneumonia: an individual participant data meta‐analysis

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan S., Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan S.

Abstract

BACKGROUND: The impact of neuraminidase inhibitors (NAIs) on influenza‐related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. METHODS: A worldwide meta‐analysis of individual participant data from 20 634 hospitalised patients with laboratory‐confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. RESULTS: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. CONCLUSIONS: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.

Full Text
View/download PDF

35. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan, Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan

Abstract

Neuraminidase inhibitors were widely used during the 2009/10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection. We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling. We included data for 29?234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70?0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41?0·56; p<0·0001). Early treatment versus no treatment was also associated with a reduction in mortality (adjusted OR 0·50; 95% CI 0·37?0·67; p<0·0001). These associat

Full Text
View/download PDF

36. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09‐related pneumonia: an individual participant data meta‐analysis

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan S., Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan S.

Abstract

BACKGROUND: The impact of neuraminidase inhibitors (NAIs) on influenza‐related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. METHODS: A worldwide meta‐analysis of individual participant data from 20 634 hospitalised patients with laboratory‐confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. RESULTS: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. CONCLUSIONS: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.

Full Text
View/download PDF

37. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan, Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan

Abstract

Neuraminidase inhibitors were widely used during the 2009/10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection. We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling. We included data for 29?234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70?0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41?0·56; p<0·0001). Early treatment versus no treatment was also associated with a reduction in mortality (adjusted OR 0·50; 95% CI 0·37?0·67; p<0·0001). These associat

Full Text
View/download PDF

38. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09‐related pneumonia: an individual participant data meta‐analysis

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan S., Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan S.

Abstract

BACKGROUND: The impact of neuraminidase inhibitors (NAIs) on influenza‐related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. METHODS: A worldwide meta‐analysis of individual participant data from 20 634 hospitalised patients with laboratory‐confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. RESULTS: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. CONCLUSIONS: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.

Full Text
View/download PDF

39. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan, Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan

Abstract

Neuraminidase inhibitors were widely used during the 2009/10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection. We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling. We included data for 29?234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70?0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41?0·56; p<0·0001). Early treatment versus no treatment was also associated with a reduction in mortality (adjusted OR 0·50; 95% CI 0·37?0·67; p<0·0001). These associat

Full Text
View/download PDF

40. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09‐related pneumonia: an individual participant data meta‐analysis

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan S., Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan S.

Abstract

BACKGROUND: The impact of neuraminidase inhibitors (NAIs) on influenza‐related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. METHODS: A worldwide meta‐analysis of individual participant data from 20 634 hospitalised patients with laboratory‐confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. RESULTS: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. CONCLUSIONS: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.

Full Text
View/download PDF

41. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan, Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan

Abstract

Neuraminidase inhibitors were widely used during the 2009/10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection. We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling. We included data for 29?234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70?0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41?0·56; p<0·0001). Early treatment versus no treatment was also associated with a reduction in mortality (adjusted OR 0·50; 95% CI 0·37?0·67; p<0·0001). These associat

Full Text
View/download PDF

42. Neuraminidase Inhibitors and Hospital Length of Stay: A Meta-analysis of Individual Participant Data to Determine Treatment Effectiveness Among Patients Hospitalized With Nonfatal 2009 Pandemic Influenza A(H1N1) Virus Infection.

Author

Venkatesan S, Myles PR, Bolton KJ, Muthuri SG, Al Khuwaitir T, Anovadiya AP, Azziz-Baumgartner E, Bajjou T, Bassetti M, Beovic B, Bertisch B, Bonmarin I, Booy R, Borja-Aburto VH, Burgmann H, Cao B, Carratala J, Chinbayar T, Cilloniz C, Denholm JT, Dominguez SR, Duarte PAD, Dubnov-Raz G, Fanella S, Gao Z, Gérardin P, Giannella M, Gubbels S, Herberg J, Higuera Iglesias AL, Hoeger PH, Hu XY, Islam QT, Jiménez MF, Keijzers G, Khalili H, Kusznierz G, Kuzman I, Langenegger E, Lankarani KB, Leo YS, Libster RP, Linko R, Madanat F, Maltezos E, Mamun A, Manabe T, Metan G, Mickiene A, Mikić D, Mohn KGI, Oliva ME, Ozkan M, Parekh D, Paul M, Rath BA, Refaey S, Rodríguez AH, Sertogullarindan B, Skręt-Magierło J, Somer A, Talarek E, Tang JW, To K, Tran D, Uyeki TM, Vaudry W, Vidmar T, Zarogoulidis P, and Nguyen-Van-Tam JS

Subjects
Adolescent, Adrenal Cortex Hormones therapeutic use, Adult, Aged, Anti-Bacterial Agents therapeutic use, Child, Enzyme Inhibitors pharmacology, Female, Humans, Male, Middle Aged, Treatment Outcome, Young Adult, Antiviral Agents therapeutic use, Enzyme Inhibitors therapeutic use, Influenza A Virus, H1N1 Subtype, Influenza, Human drug therapy, Influenza, Human epidemiology, Length of Stay, Neuraminidase antagonists & inhibitors, Pandemics
Abstract

Background: The effect of neuraminidase inhibitor (NAI) treatment on length of stay (LoS) in patients hospitalized with influenza is unclear., Methods: We conducted a one-stage individual participant data (IPD) meta-analysis exploring the association between NAI treatment and LoS in patients hospitalized with 2009 influenza A(H1N1) virus (A[H1N1]pdm09) infection. Using mixed-effects negative binomial regression and adjusting for the propensity to receive NAI, antibiotic, and corticosteroid treatment, we calculated incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Patients with a LoS of <1 day and those who died while hospitalized were excluded., Results: We analyzed data on 18 309 patients from 70 clinical centers. After adjustment, NAI treatment initiated at hospitalization was associated with a 19% reduction in the LoS among patients with clinically suspected or laboratory-confirmed influenza A(H1N1)pdm09 infection (IRR, 0.81; 95% CI, .78-.85), compared with later or no initiation of NAI treatment. Similar statistically significant associations were seen in all clinical subgroups. NAI treatment (at any time), compared with no NAI treatment, and NAI treatment initiated <2 days after symptom onset, compared with later or no initiation of NAI treatment, showed mixed patterns of association with the LoS., Conclusions: When patients hospitalized with influenza are treated with NAIs, treatment initiated on admission, regardless of time since symptom onset, is associated with a reduced LoS, compared with later or no initiation of treatment., (© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Published
2020
Full Text
View/download PDF

43. Circulating chromogranin B levels in patients with acute respiratory failure: data from the FINNALI Study.

Author

Myhre PL, Stridsberg M, Linko R, Okkonen M, Nygård S, Christensen G, Pettilä V, Omland T, and Røsjø H

Subjects
Acute Disease, Aged, Female, Follow-Up Studies, Humans, Intensive Care Units statistics & numerical data, Male, Middle Aged, Natriuretic Peptide, Brain blood, Prognosis, Proportional Hazards Models, Respiratory Insufficiency diagnosis, Respiratory Insufficiency mortality, Survival Rate, Biomarkers blood, Chromogranin B blood, Respiratory Insufficiency blood
Abstract

Purpose: Circulating chromogranin B (CgB) levels are increased in situations characterized by systemic and myocardial stress, but whether CgB provides prognostic information in patients with acute respiratory failure (ARF) is unknown., Methods: We included 584 patients with ARF, defined as ventilatory support >6 h, and with blood samples available on Intensive Care Unit (ICU) admission and day 3 (n = 479). CgB levels were measured by radioimmunoassay and follow-up was 90 days., Results: One-hundred-sixty-nine patients (29%) died during follow-up. Admission CgB levels separated non-survivors from survivors: median 1234 (Q1-3 989-1742) vs. 917 (753-1224) pmol/L, respectively, p < 0.001. CgB levels on ICU admission (logarithmically transformed) were associated with time to death after adjustment for established risk indices available on ICU admission, including N-terminal pro-B-type natriuretic levels: HR 2.62 (95%C.I. 1.82-3.77), p < 0.001. Admission CgB levels also improved prognostication on top of SOFA and SAPS II scores as assessed by Cox regression analyses and the category-free net reclassification index. The area under the curve (AUC) for admission CgB levels to separate survivors and non-survivors was 0.72 (95%CI 0.67-0.76), while the AUC on day 3 was 0.60 (0.54-0.66)., Conclusions: CgB levels measured on ICU admission provided additional prognostic information to established risk indices in ARF patients.

Published
2017
Full Text
View/download PDF

44. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: an individual participant data meta-analysis.

Author

Muthuri SG, Venkatesan S, Myles PR, Leonardi-Bee J, Lim WS, Al Mamun A, Anovadiya AP, Araújo WN, Azziz-Baumgartner E, Báez C, Bantar C, Barhoush MM, Bassetti M, Beovic B, Bingisser R, Bonmarin I, Borja-Aburto VH, Cao B, Carratala J, Cuezzo MR, Denholm JT, Dominguez SR, Duarte PA, Dubnov-Raz G, Echavarria M, Fanella S, Fraser J, Gao Z, Gérardin P, Giannella M, Gubbels S, Herberg J, Higuera Iglesias AL, Hoeger PH, Hoffmann M, Hu X, Islam QT, Jiménez MF, Kandeel A, Keijzers G, Khalili H, Khandaker G, Knight M, Kusznierz G, Kuzman I, Kwan AM, Lahlou Amine I, Langenegger E, Lankarani KB, Leo YS, Linko R, Liu P, Madanat F, Manabe T, Mayo-Montero E, McGeer A, Memish ZA, Metan G, Mikić D, Mohn KG, Moradi A, Nymadawa P, Ozbay B, Ozkan M, Parekh D, Paul M, Poeppl W, Polack FP, Rath BA, Rodríguez AH, Siqueira MM, Skręt-Magierło J, Talarek E, Tang JW, Torres A, Törün SH, Tran D, Uyeki TM, van Zwol A, Vaudry W, Velyvyte D, Vidmar T, Zarogoulidis P, and Nguyen-Van-Tam JS

Subjects
Adolescent, Adrenal Cortex Hormones therapeutic use, Adult, Anti-Bacterial Agents therapeutic use, Child, Child, Preschool, Enzyme Inhibitors therapeutic use, Female, Humans, Influenza, Human epidemiology, Influenza, Human mortality, Influenza, Human virology, Male, Middle Aged, Odds Ratio, Pneumonia, Viral diagnostic imaging, Pneumonia, Viral epidemiology, Treatment Outcome, Young Adult, Antiviral Agents therapeutic use, Influenza A Virus, H1N1 Subtype drug effects, Influenza A Virus, H1N1 Subtype enzymology, Influenza, Human drug therapy, Neuraminidase antagonists & inhibitors, Pneumonia, Viral drug therapy, Pneumonia, Viral virology
Abstract

Background: The impact of neuraminidase inhibitors (NAIs) on influenza-related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection., Methods: A worldwide meta-analysis of individual participant data from 20 634 hospitalised patients with laboratory-confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) 'pandemic influenza'. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids., Results: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64-1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44-1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71-1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55-0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54-0·85; P = 0·001)]., Conclusions: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support., (© 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.)

Published
2016
Full Text
View/download PDF

45. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data.

Author

Muthuri SG, Venkatesan S, Myles PR, Leonardi-Bee J, Al Khuwaitir TS, Al Mamun A, Anovadiya AP, Azziz-Baumgartner E, Báez C, Bassetti M, Beovic B, Bertisch B, Bonmarin I, Booy R, Borja-Aburto VH, Burgmann H, Cao B, Carratala J, Denholm JT, Dominguez SR, Duarte PA, Dubnov-Raz G, Echavarria M, Fanella S, Gao Z, Gérardin P, Giannella M, Gubbels S, Herberg J, Iglesias AL, Hoger PH, Hu X, Islam QT, Jiménez MF, Kandeel A, Keijzers G, Khalili H, Knight M, Kudo K, Kusznierz G, Kuzman I, Kwan AM, Amine IL, Langenegger E, Lankarani KB, Leo YS, Linko R, Liu P, Madanat F, Mayo-Montero E, McGeer A, Memish Z, Metan G, Mickiene A, Mikić D, Mohn KG, Moradi A, Nymadawa P, Oliva ME, Ozkan M, Parekh D, Paul M, Polack FP, Rath BA, Rodríguez AH, Sarrouf EB, Seale AC, Sertogullarindan B, Siqueira MM, Skręt-Magierło J, Stephan F, Talarek E, Tang JW, To KK, Torres A, Törün SH, Tran D, Uyeki TM, Van Zwol A, Vaudry W, Vidmar T, Yokota RT, Zarogoulidis P, and Nguyen-Van-Tam JS

Subjects
Adolescent, Adult, Child, Female, Hospitalization, Humans, Influenza, Human mortality, Male, Middle Aged, Proportional Hazards Models, Treatment Outcome, Young Adult, Antiviral Agents therapeutic use, Enzyme Inhibitors therapeutic use, Influenza A Virus, H1N1 Subtype, Influenza, Human drug therapy, Neuraminidase antagonists & inhibitors, Oseltamivir therapeutic use, Pandemics, Zanamivir therapeutic use
Abstract

Background: Neuraminidase inhibitors were widely used during the 2009-10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection., Methods: We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling., Findings: We included data for 29,234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70-0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41-0·56; p<0·0001). Early treatment versus no treatment was also associated with a reduction in mortality (adjusted OR 0·50; 95% CI 0·37-0·67; p<0·0001). These associations with reduced mortality risk were less pronounced and not significant in children. There was an increase in the mortality hazard rate with each day's delay in initiation of treatment up to day 5 as compared with treatment initiated within 2 days of symptom onset (adjusted hazard ratio [HR 1·23] [95% CI 1·18-1·28]; p<0·0001 for the increasing HR with each day's delay)., Interpretation: We advocate early instigation of neuraminidase inhibitor treatment in adults admitted to hospital with suspected or proven influenza infection., Funding: F Hoffmann-La Roche., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Published
2014
Full Text
View/download PDF

46. [Incidence, treatment and prognosis of acute respiratory failure in Finland--the FINNALI study].

Author

Varpula T, Linko R, and Pettilä V

Subjects
Acute Lung Injury therapy, Finland epidemiology, Humans, Incidence, Outcome Assessment, Health Care, Respiration, Artificial, Respiratory Insufficiency therapy, Acute Lung Injury mortality, Respiratory Insufficiency mortality
Abstract

In a cohort study covering whole Finland, the incidence of acute respiratory failure was higher than in previous international studies. The number of patients fulfilling the diagnostic criteria for acute lung injury and acute respiratory failure remained, however, smaller than that reported in international comparative data. The 90-day mortality was 31% and one-year mortality 35%. Recommended airway pressure levels were followed in ventilatory support treatment, but tidal volumes were larger than those in recent therapeutic trials. Patients outcome could probably be further improved by centralizing intensive care services.

Published
2010

Catalog

Books, media, physical & digital resources
See catalog results