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J Korean Soc Emerg Med > Volume 30(3); 2019 > Article
Journal of The Korean Society of Emergency Medicine 2019;30(3): 265-272.
성인 바이러스성 폐렴의 계절적 변화와 사망률 분석
이지연1, 김윤정1, 이의선2, 이윤선1
1울산대학교 의과대학 서울아산병원 응급의학과
2고려대학교 의과대학 구로병원 응급의학과
Seasonal trend and mortality in adults with viral pneumonia
Ji-Yeon Lee1, Youn-Jung Kim1, Eu Sun Lee2, Yoon-Seon Lee1
1Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Department of Emergency Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
Correspondence  Yoon-Seon Lee ,Tel: 02-3010-5905, Fax: 02-3010-3360, Email: ysdoc@amc.seoul.kr,
Received: September 10, 2018; Revised: October 17, 2018   Accepted: October 19, 2018.  Published online: June 30, 2019.
ABSTRACT
Objective:
Viral infections are being identified increasingly in patients with pneumonia and can be fatal, particularly in immune-compromised patients. This study examined the seasonal trend and mortality in adult patients with viral pneumonia.
Method:
Retrospective data of adult patients who visited the emergency room and were diagnosed with viral pneumonia was collected between January 2012 and December 2015 at a tertiary referral center. The monthly incidence of each viral pathogen and in-hospital mortality were analyzed.
Results:
A total of 1,179 patients were analyzed. The mean age was 66.0 years and male comprised 60.0% of cases. Multiple viral infections and viral-bacterial co-infection were found in 5.2% and 24.7% of patients, respectively. The underlying diseases were as follows: diabetes mellitus in 32.8%, malignancy in 30.3%, and chronic lung disease in 30.9%. Inhospital mortality occurred in 7.9% of the total patients. Rhinovirus was the most common viral pathogen throughout the year. Influenza A was the most common from January to March and rhinovirus was the most common from September to November. Among the viral pathogens, a coronavirus infection resulted in the highest mortality of 12.6% but there was no significant difference in mortality among the viral pathogens. Multivariate analysis for in-hospital mortality revealed a viralbacterial co-infection (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.02-2.34), malignancy (OR, 2.34; 95% CI, 1.48-3.71), C-reactive protein (CRP; OR, 1.04; 95% CI, 1.02-1.07), CURB-65 score 2 (OR, 2.46; 95% CI, 1.47-4.12), and CURB-65 score ≥3 (OR, 4.60; 95% CI, 2.31-9.16) to be significantly associated with mortality.
Conclusion:
The outcome from viral pneumonia was poor in adult patients. A viral-bacterial co-infection, malignancy, elevated CRP, and CURB-65 score were significant predictors of mortality.
Key words: Viral pneumonia; Mortality; Risk factors; Outcome
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