Introduction. Acute respiratory distress syndrome (ARDS) is a significant
complication in patients with type A influenza (H1N1) due to the severity of
the disease and adverse outcome. Objective. The aim of the study was to
identify risk factors for the development of ARDS in patients with type A
influenza (H1N1) and outcome of ARDS. Methods. The research was conducted as
a case series study, and included patients admitted at the Clinical Center in
Kragujevac during the 2009 and 2010 flu season. Data for the study were
obtained from patients? medical records, inclusion criteria having been
determined in accordance with recommendations of the Expert Methodological
Guide for Controlling Spread of Pandemic Influenza in the Republic of Serbia.
Primary data analysis was performed using descriptive statistics and a
statistical method for testing hypotheses. Dependence analysis was performed
using simple logistic regression. The statistical hypotheses were tested at
the 0.05 level of significance. Results. The case group consisted of 14
patients who developed ARDS, while the control group was composed of 34
patients with influenza but without ARDS (group alignment performed by age).
Simple logistic regression analysis identified the following risk factors for
the development of ARDS: diabetes mellitus type 1 or 2 (p=0.028), high levels
of C-reactive protein (p=0.004), aspartate-aminotransferase (p=0.006), urea
(p=0.028), creatine kinase (p=0.001), lactate-dehydrogenase (p=0.005) and
longer time elapsed from disease symptoms onset to the administration of
specific antiviral therapy administration (p=0.021). Conclusion. The research
showed that diabetes, late initiation of antiviral therapy and some
laboratory tests are risk factors for ARDS development in patients with type
A influenza (H1N1).
ABO blood type: a window into the genetics of acute respiratory distress syndrome susceptibility
