Complications, clinical outcomes and treatment prescribed for adults hospitalised with influenza, 2007–2008 (n=754)
| Complications and clinical outcomes | n (%) |
| Complications, any* | 581 (77.1) |
| Cardiorespiratory complication (pneumonia, acute bronchitis, acute exacerbation of underlying chronic respiratory conditions, heart failure, acute coronary syndrome, arrhythmia and acute cerebrovascular events) | 493 (65.4) |
| Secondary bacterial infection† | 68 (9.0) |
| Supplemental oxygen required | 401 (53.2) |
| Ventilatory support required‡ | 41 (5.4) |
| Direct discharge from acute hospitals | 562 (74.5) |
| Extended care in subacute hospitals | 165 (21.9) |
| Duration of hospitalisation >5 days | 319 (44.6) |
| Duration of hospitalisation >10 days | 177 (24.8) |
| Death during the same hospital stay§ | 39 (5.2) |
| Treatment prescribed | |
| Antiviral use (oseltamivir) | 395 (52.4) |
| Initiated ≤2 days from onset | 307 (40.7) |
| Initiated ≤4 days from onset | 377 (50.0) |
| Early discontinuation of antiviral¶ | 7 (1.8) |
| Antibacterial | 693 (91.9) |
↵* Patients may have ≥1 complication (see text).19 25 26 Other complications include syncope/presyncope, dehydration, renal impairment, decreased conscious level, confusion and metabolic disturbances (158 episodes).
↵† Sputum culture confirmed bacterial infection (Streptococcus pneumoniae 8. Staphylococcus aureus 8, Haemophilus influenzae 15, Moraxella catarrhalis 2, Pseudomonas aeruginosa 18, Klebsiella spp. 10, other Gram-negative bacilli 7, other Gram-positive cocci 3; mixed infection in a few cases) at presentation. Another 28 (3.7%) patients developed nosocomial infection (P aeruginosa, Acinectobacter spp., other resistant enterobacteriaceae, methicillin-resistant S aureus). The bacterial pathogen was identified in 31% of fatal cases (community-acquired 5, nosocomial 8). Antibacterials were given according to standard recommendations.19 48
↵‡ Intubated and received mechanical ventilation, or non-invasive ventilatory support.
↵§ Death due to all causes during the same period of hospitalisation. 35 patients died within the first 3 weeks of hospitalisation.
↵¶ Reasons for discontinuation of oseltamivir treatment (other than death): vomiting 1, dizziness 1, cannot tolerate oral medication 2, confusion in patients with underlying dementia/schizophrenia 3.