Epidemiology of Australian influenza-related paediatric intensive care unit admissions, 1997-2013

Kaczmarek, Marlena C., Ware, Robert S., Coulthard, Mark G., McEniery, Julie and Lambert, Stephen B. (2016) Epidemiology of Australian influenza-related paediatric intensive care unit admissions, 1997-2013. PLoS ONE, 11 3: e0152305.1-e0152305.12. doi:10.1371/journal.pone.0152305


Author Kaczmarek, Marlena C.
Ware, Robert S.
Coulthard, Mark G.
McEniery, Julie
Lambert, Stephen B.
Title Epidemiology of Australian influenza-related paediatric intensive care unit admissions, 1997-2013
Journal name PLoS ONE   Check publisher's open access policy
ISSN 1932-6203
Publication date 2016-03-01
Year available 2016
Sub-type Article (original research)
DOI 10.1371/journal.pone.0152305
Open Access Status DOI
Volume 11
Issue 3
Start page e0152305.1
End page e0152305.12
Total pages 12
Place of publication San Francisco, United States
Publisher Public Library of Science
Collection year 2017
Language eng
Formatted abstract
Background
Influenza virus predictably causes an annual epidemic resulting in a considerable burden of illness in Australia. Children are disproportionately affected and can experience severe illness and complications, which occasionally result in death.

Methods
We conducted a retrospective descriptive study using data collated in the Australian and New Zealand Paediatric Intensive Care (ANZPIC) Registry of influenza-related intensive care unit (ICU) admissions over a 17-year period (1997–2013, inclusive) in children <16 years old. National laboratory-confirmed influenza notifications were used for comparison.

Results
Between 1997 and 2013, a total of 704 influenza-related ICU admissions were recorded, at a rate of 6.2 per 1,000 all-cause ICU admissions. Age at admission ranged from 0 days and 15.9 years (median = 2.1 years), with 135 (19.2%) aged <6 months. Pneumonia/pneumonitis and bronchiolitis were the most common primary diagnoses among influenza-related admissions (21.9% and 13.6%, respectively). More than half of total cases (59.2%) were previously healthy (no co-morbidities recorded), and in the remainder, chronic lung disease (16.7%) and asthma (12.5%) were the most common co-morbidities recorded. Pathogen co-detection occurred in 24.7% of cases, most commonly with respiratory syncytial virus or a staphylococcal species. Median length of all ICU admissions was 3.2 days (range 2.0 hours– 107.4 days) and 361 (51.3%) admissions required invasive respiratory support for a median duration of 4.3 days (range 0.2 hours– 107.5 days). There were 27 deaths recorded, 14 (51.9%) in children without a recorded co-morbidity.

Conclusion
Influenza causes a substantial number of ICU admissions in Australian children each year with the majority occurring in previously healthy children.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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