| Sažetak | CILJ ISTRAŽIVANJA:
Cilj rada je bio otkriti postojanje rizičnih čimbenika za nastanak upale pluća kod inficiranih
virusom H1N1. Pretpostavka je bila da će bolesti koje primarno zahvaćaju respiratorni sustav
(astma, bronhitis, druge plućne bolesti) predstavljati jedan od rizičnih čimbenika. Također smo smatrali da će i dijabetes, starija životna dob, mlađa životna dob, trudnoća, kardiovaskularne bolesti kao i imunokompromitirana stanja pogodovati razvoju upale pluća.
USTROJ ISTRAŽIVANJA:
Povijesna kohortna studija. U istraživanje su bili uključeni svi hospitalizirani bolesnici zaraženi virusom influence A (H1N1), u razdoblju od rujna 2009. god. do veljače 2010. god. Taj uzorak bolesnika podijelili smo potom u dvije skupine ovisno o prisutnosti upale pluća te smo istraživali čimbenike koji doprinose nastanku upale pluća.
MJESTO ISTRAŽIVANJA:
KBC Split: Odjel za zarazne bolesti i mikrobiologiju s parazitologijom, Klinika za plućne
bolesti, Klinika za ženske bolesti i porode, Klinika za dječije bolesti.
Služba za epidemiologiju zaraznih bolesti Nastavnog zavoda za javno zdravstvo Splitsko-dalmatinske županije.
SUDIONICI:
U istraživanje smo uključili hospitalizirane ispitanike s Klinike za dječje bolesti, Klinike za
plućne bolesti, Klinike za ženske bolesti i porode i Odjela za zarazne bolesti i mikrobiologiju s parazitologijom. Uključeni su samo oni s dokazanom infekcijom virusom influence A(H1N1) jednom od metoda molekularne biologije te laboratorijski i radiološki potvrđenom upalom pluća. Isključili smo oboljele od upale pluća s negativnim nalazom virusa influence A(H1N1). Ukupan broj ispitanika je 69. Od toga je 30 ispitanica i 39 ispitanika. Broj ispitanika sa upalom pluća bio je 39, a bez upale pluća 30. Ispitanici su bili u dobi od 4 mjeseca do 86 godina.
GLAVNE MJERE ISHODA:
Glavne mjere ishoda su: dob ( <18 godina, 19-35 godina, 36-64 godine, >65 godina),
komorbiditet ( kardiovaskularne bolesti, kronična opstruktivna plućna bolest, druge plućne
bolesti, trudnoća, imunokompromitirana stanja, pušenje).
REZULTATI:
Bolesnici s pneumonijom značajno su učestalije bili aktivni pušači u odnosu na bolesnike bez
pneumonije (χ² test=20,331; df=2; P<0,001). Muški spol značajno je učestalije (69,2%) imao
pneumoniju, u odnosu na ženski spol (30,8%) (P=0,015). Nije postojala značajna razlika u
prisutnosti pneumonije između različitih dobnih skupina, kao ni imunokompromitiranih stanja, drugih kroničnih plućnih bolesti ni kardijalnih bolesti ispitanika u istraživanom uzorku. Nakon isključenja varijabli zbog manjka podataka za regresijsku analizu (KOPB, trudnoća, dijabetes mellitus), u prediktivnom modelu kao značajni rizični čimbenik nastanka pneumonije pokazalo se pušenje (OR=15,819; 95%CI=2,716-92,138, P=0,002).
ZAKLJUČCI:
U našem istraživanju, kao prediktivni čimbenik rizika dokazano je aktivno pušenje. Ostali rizični čimbenici vjerovatno su odstupali od istraživanja drugih autora zbog manjeg uzorka ispitanika. |
| Sažetak (engleski) | OBJECTIVES:
The aim of this research was to define risk factors for developing pneumonia in patients infected by H1N1 influenza virus. Our assumption was that conditions that primarly affect respiratory system (asthma, bronchitis, other lung diseases) will be one of risk factors. We also considered diabetes, elder life age, young age, pregnancy, cardiovascular diseases and imunocompromised conditions as risk factors.
DESIGN:
Historical cohort study. In our research were included all hospitalized patients infected with
influenza A (H1N1)virus, in time between september 2009. and february 2010. This sample was then divided in two groups depending on presence or absense of pneumonia.
SETTINGS:
This research was carried out at the Clinic for pulmonary diseases, Department of infectious
diseases and microbiology and parasitology, Department of obstetrics and gynecology and Clinic for pediatric diseases at Clinical hospital centre Split.
Department of Infectious Disease Epidemiology of the Institute of Public Health, Split-Dalmatia County.
PARTICIPANTS:
The study included subjects hospitalized with the Clinic for pediatric diseases, Department of
pulmonary diseases, Department of obstetrics and gynecology and Department of infectious
diseases and microbiology and parasitology. Only those who had proven infection with influenza A (H1N1), with one of the methods of molecular biology, laboratory and radiological confirmed pneumonia were included in this research. We excluded those suffering from pneumonia with negative findings of influenza virus A (H1N1). Total number of patients was 69: 30 females and 39 males. Number of patients with pneumonia was 39, and without pneumonia 30. Patiens were aged between 4 months and 86 years.
MAIN OUTCOME MEASURES:
The main outcome measures were: age (<18 years, 19-35 years, 36-64 years,> 65 years),
comorbidities (cardiovascular disease, chronic obstructive pulmonary disease, lung disease,
pregnancy, immunocompromised status, smoking).
RESULTS:
Patients with pneumonia were significantly more frequent in current smokers than patients
without pneumonia. Male gender was significantly more frequent pneumonia (69,2%), compared to the female (30.,8%) (P=0,015). There was no significant difference in the presence of pneumonia among different age groups, as well as immunocompromised status, other chronic lung disease or cardiac disease in patients in the studied sample. After exclusions due to lack of data variables for regression analysis (COPD, pregnancy, diabetes mellitus), in the predictive model as a significant risk factor of pneumonia has been proved smoking (OR=15,819; 95%CI=2,716-92,138, P=0,002).
CONCLUSIONS:
In our study, as a predictive risk factor has been proven active smoking. Other risk factors are
likely to differ from studies of other authors because of the smaller sample of respondents. |
