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首页> 外文期刊>The Internet Journal of Emergency and Intensive Care Medicine >Urban Inner-City Minority New Yorkers Hospitalized With Novel Swine-Origin Influenza A H1N1 Virus Illness During The Pandemic Of April – June 2009
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Urban Inner-City Minority New Yorkers Hospitalized With Novel Swine-Origin Influenza A H1N1 Virus Illness During The Pandemic Of April – June 2009

机译：2009年4月至6月大流行期间，纽约市市区少数民族因新型猪源性甲型H1N1流感而住院

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Background: New York City (NYC) was an epicenter in 2009 of a novel SOIV illness outbreak in the US. Due to barriers to early care and prevalence of health risks, severity among urban inner-city minority patients is greater. Disparities of severity and outcomes have been described based on age and co-morbidity. We report the 2009 SOIV illness characteristics and comparison between young and older urban minority New Yorkers during the 2009 pandemic. Methods: A retrospective study of SOIV-illness among inner-city minority New Yorkers hospitalized in a city-hospital setting at South Bronx was conducted. Two hundred and ninety eight individuals had a positive screening rapid influenza antigen diagnostic (RIDT) test. Among them, 40 adults (> 18 years age) and 40 children were hospitalized with SOIV illness. Results: All study patients were urban New Yorkers of Hispanic (75%) or African American background (25%). Fourteen tested RIDT +, 5 had polymerase chain reaction (PCR) + and 61 had both positive. Adult’s SOIV illness were mostly young (median age 44.5 years), but among children there was no age predilection. Frequent co-morbidities (75% in adults & 47.5% in children) such as chronic airway disease, diabetes and obesity were noted. Adults requiring intensive care (37.5%) had higher prevalence of diabetes, were severely ill on admission ( median SOFA & APACHE-II scores 13 & 31 respectively), had greater length of stay (median 6 days) and significant mortality (26.6 %). Only adults had organ dysfunction (42.5%). About 10% of adults died who mostly were young and obese. Compared to adults, children had less severe SOIV illness not associated with death, intensive care admission or organ dysfunction. Conclusion: This is the first detailed study of hospitalized pediatric and adult New Yorkers highlighting age-related health disparities due to 2009 SOIV illness among urban inner-city ethnic minority. In order to provide early and effective care to SOIV-infected inner-city patients and optimize outcomes, health-care providers should be aware of clinical risks and differences in disease characteristics within this population. Introduction Infection due to 2009 novel swine origin Influenza-A H1N1 virus (SOIV) has emerged as a global pandemic (1). In the United States (US) and worldwide, several case series of severe disease and deaths have been reported. (2-9). In the US, New York City (NYC) was the first epicenter of the SOIV illness outbreak (4). US surveillance data reveals that 6.9% of all deaths were due to influenza and pneumonia, higher than the epidemic threshold of 6.6% (10). Currently, there are no studies on differences among characteristics of hospitalized SOIV infected inner-city minority adult and pediatric patients, except for a recent report on SOIV features among New Yorkers (4). Lincoln Medical and Mental Health center (LMMHC), a university-affiliated urban public NYC Health and Hospital Corporation institution serving inner-city minority New Yorkers in the South Bronx, encountered a number of cases with Influenza-Like Illness (ILI) during the 2009 outbreak. The characteristics and comparison of hospitalized pediatric and adult with SOIV illness are reported. Methods and Materials A retrospective observational study was conducted on adult and pediatric patients hospitalized for at least 24 hours with ILI and laboratory evidence of “probable” or “confirmed” 2009 SOIV-illness to LMMHC between April-July 2009. The study protocol and data abstraction tools were approved by the Institutional Review Board and informed consent was waived. Patients with ILI were identified through daily reports from the emergency department(ED) and hospital wards. Data on demographic features, co-morbidity, clinical characteristics, laboratory tests and outcomes were extracted by 2 trained independent investigators using a standardized data-collection tool. Data regarding ED visits including respiratory infections utilizing ICD-9 codes were als
机译：背景：纽约市（NYC）在2009年是美国新发SOIV疾病暴发的震中。由于早期护理的障碍和健康风险的普遍存在，市区内少数民族患者的严重性更高。已经根据年龄和合并症描述了严重程度和预后的差异。我们报告了2009年SOIV的疾病特征，以及2009年大流行期间纽约市区年轻人和老年人之间的比较。方法：对南布朗克斯市住院的纽约市内少数城市居民的SOIV病进行了回顾性研究。 298个个体的筛查快速流感抗原诊断（RIDT）测试呈阳性。其中，有40名成年人（> 18岁）和40名儿童因SOIV疾病住院。结果：所有研究患者均为西班牙裔城市纽约人（75％）或非裔美国人背景（25％）。测试的14个RIDT +，5个具有聚合酶链反应（PCR）+和61个均为阳性。成人的SOIV病大多是年轻的（中位年龄为44.5岁），但是儿童中没有年龄偏爱。注意到常见的合并症（成人为75％，儿童为47.5％），例如慢性气道疾病，糖尿病和肥胖症。需要重症监护的成年人（37.5％）的糖尿病患病率更高，入院时病情严重（中位SOFA和APACHE-II得分分别为13和31），住院时间更长（中位数为6天），死亡率较高（26.6％） 。只有成年人患有器官功能障碍（42.5％）。约有10％的成年人死亡，其中大多数是年轻人和肥胖者。与成年人相比，儿童的SOIV病严重程度与死亡，重症监护或器官功能障碍无关。结论：这是首次对住院的小儿和成年纽约人进行的详细研究，该研究突出了2009年城市居民中SOIV病引起的与年龄相关的健康差异。为了向感染SOIV的市中心患者提供早期有效的护理并优化结果，医疗保健提供者应了解该人群的临床风险和疾病特征差异。引言由于2009年新的猪源性流感引起的感染A型H1N1流感病毒（SOIV）已成为全球大流行（1）。在美国和世界范围内，已经报道了一系列严重的疾病和死亡案例。 （2-9）。在美国，纽约市（NYC）是SOIV疾病暴发的第一个震中（4）。美国监测数据显示，所有死亡中有6.9％是由于流感和肺炎引起的，高于6.6％的流行阈值（10）。目前，除了最近关于纽约人群中SOIV特征的报道外，尚无关于住院SOIV感染的市区少数成年人和儿科患者特征之间差异的研究（4）。林肯医学与心理健康中心（LMMHC）是一家隶属于大学的城市公共纽约市卫生与医院公司机构，为南布朗克斯的内城区少数民族纽约人提供服务，2009年期间发生了许多流感样疾病（ILI）的案例暴发。报道了住院的小儿和成年人患有SOIV疾病的特征和比较。方法和材料对2009年4月至7月之间住院的至少24小时患有ILI的成年和小儿患者进行回顾性观察研究，并提供实验室证据表明“ 2009年可能或已确诊的LMVHC SOIV疾病”。研究方案和数据机构审查委员会批准了抽象工具，并放弃了知情同意。通过急诊科和医院病房的每日报告确定了ILI患者。由2名训练有素的独立研究人员使用标准化数据收集工具提取有关人口统计学特征，合并症，临床特征，实验室检查和结果的数据。有关急诊就诊的数据，包括使用ICD-9代码的呼吸道感染，均为als

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