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Individual and seasonal determinants of death among influenza patients in intensive care units

2026-02-26Artigo científico Acesso aberto
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dc.contributor.authorvon Schreeb, Sebastian
dc.contributor.authorFirme, Ana
dc.contributor.authorFerreira, Mariana
dc.contributor.authorCastro Silva, Carina
dc.contributor.authorVidal-Castro, Joana
dc.contributor.authorSalgado Crisóstomo, Eunice Das Neves
dc.contributor.authorSousa Marques, Catarina Filipa
dc.contributor.authorBaptista Monteiro, Hugo Filipe
dc.contributor.authorFroes, Filipe
dc.contributor.authorLeitão, Rui Pedro
dc.contributor.authorDanis, Kostas
dc.contributor.authorMarinho Falcão, Isabel
dc.contributor.authorVasconcelos, Paula
dc.contributor.authorRicoca Peixoto, Vasco
dc.contributor.institutionEscola Nacional de Saúde Pública (ENSP)
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - Pólo ENSP
dc.contributor.institutionCentro de Investigação em Saúde Pública (CISP/PHRC)
dc.contributor.pblEuropean Centre for Disease Prevention and Control
dc.date.accessioned2026-05-20T15:37:05Z
dc.date.available2026-05-20T15:37:05Z
dc.date.issued2026-02-26
dc.descriptionPublisher Copyright: © 2026, European Centre for Disease Prevention and Control (ECDC). All rights reserved.
dc.description.abstractBackground: Portugal is establishing a surveillance system for severe acute respiratory infection (SARI). Data from its existing influenza surveillance system in intensive care units (ICU), operating since 2012, has not yet been analysed. Aim: We aimed to identify individual and seasonal determinants of death from influenza in ICUs to inform ICU capacity planning, triage and SARI surveillance. Methods: We conducted a retrospective cohort study of laboratory-confirmed influenza cases admitted to 27 ICUs between 2012 and 2024. Covariates included demographics, comorbidities, season, influenza type, seasonal and weekly influenza caseload in the ICU and weekly ICU occupancy. We calculated case fatality rates and adjusted risk ratios (aRR) for death during ICU admission using log-binomial regression. Directed acyclic graphs informed model-specific adjustments, including age, sex, influenza type and comorbidities. Results: Of 1,071 cases with known outcome, 262 (24%) died. Case fatality rates were higher among patients with chronic liver disease (aRR: 2.0; 95% CI: 1.5–2.6), cancer (aRR: 1.6; 95% CI: 1.1–2.1) and during a high caseload season (aRR: 1.52; 95% CI: 1.16–2.05). Case fatality rates increased with age and were highest for those aged ≥80 years (aRR: 11; 95% CI: 2.4–184), compared with 0–19-year-olds. Conclusion: Liver disease, cancer and older age were associated with increased fatality. Case fatality was higher in seasons with higher caseloads but showed no significant variation within seasons and did not increase during influenza peaks. These findings inform ICU triage and capacity planning for future seasons and support the implementation of broader SARI surveillance.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent359775
dc.identifier.doi10.2807/1560-7917.ES.2026.31.8.2500505
dc.identifier.issn1025-496X
dc.identifier.otherPURE: 163209923
dc.identifier.otherPURE UUID: fe2ae601-7322-4644-bc6b-39833fc94ecf
dc.identifier.otherScopus: 105031698678
dc.identifier.otherPubMed: 41755721
dc.identifier.otherPubMedCentral: PMC13074343
dc.identifier.otherWOS: 001709674100001
dc.identifier.otherORCID: /0000-0002-7529-8206/work/215300928
dc.identifier.urihttp://hdl.handle.net/10362/203256
dc.identifier.urlhttps://www.scopus.com/pages/publications/105031698678
dc.language.isoeng
dc.peerreviewedyes
dc.subjectEpidemiology
dc.subjectMicrobiology
dc.subjectImmunology and Microbiology (miscellaneous)
dc.subjectPublic Health, Environmental and Occupational Health
dc.subjectMicrobiology (medical)
dc.subjectVirology
dc.subjectInfectious Diseases
dc.subjectSDG 3 - Good Health and Well-being
dc.titleIndividual and seasonal determinants of death among influenza patients in intensive care unitsen
dc.title.subtitlea retrospective cohort study, Portugal, 2012 to 2024en
dc.typejournal article
degois.publication.issue8
degois.publication.titleEUROSURVEILLANCE
degois.publication.volume31
dspace.entity.typePublication
rcaap.rightsopenAccess

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