| Summary: | 碩士 === 國立陽明大學 === 醫務管理研究所 === 100 === Background:
The 2009 pandemic influenza virus (H1N1) is a brand new virus causing a global death rate of 0.04% - 1.47% which is shown by studies conducted by the World Health Organization(WHO). This virus has been one of the major global epidemic of influenza viruses and it has brought about 1134 critically ill patients in Taiwan. Asthma is a substantial disease which leads to a worldwide increase of medical expenditure and mortality and this disease is easily triggered by viral infection. It is reported that viral infection could induce aggravation of asthma and increase the probability of hospitalization due to asthma.
Objectives:
This study aims to reduce the incidence of H1N1-induced asthma and its related medical expenditure. For addressing this aim, the objectives are drawn as: 1. Exploring whether H1N1 infection induces asthma attack, increases severity of asthma, and prolongs hospitalization of asthma patients. 2. Examining whether asthmatic patients are vulnerable to be infected by H1N1 virus.
Methods:
The samples of this cross-sectional study was collected by reviewing medical records of the patients who were admitted to a dedicated Hospital taking care of patients with infectious diseases in Taipei due to H1N1 infection during May to December 2009. With regard to data analysis, the 19th edition of the SPSS statistical software was used and the statistical analysis was based on the characteristics of research variables and research hypotheses. The basic informations of cases were demonstrated by way of description of each variable as frequency of distribution, percentage and other methods. As to clinical symptoms, asthma and influenza-related analysis, it was implemented by using descriptive statistics, chi-square test (Chi-square; x2), and independent samples T-test (T-test) in order to test the correlations. The results of these analyses were examined by two-tailed test and p value less than 0.05 indicates that the difference is statistically significant.
Results:
Among the 118 hospitalized patients with positive result of type A influenza infection by rapid test, the average hospitalization duration is 4.01 days and the average age is 16.37. In advance, 74 of these hospitalized patients receive RT-PCR test and 39 cases reveal positive result of RT-PCR while 35 cases show negative result of this test. As scrutinizing the results, the major findings are: 1.The male to female ratio is 2.6 among the RT-PCR positive cases; 2. The majority of RT-PCR-positive patients are students which account for 51.3%; 3. The major complication is pneumonia which accounts for 58.97% and 48.57% in RT-PCR positive patients and RT-PCR negative ones, respectively; 4. The prevalence of asthma attack in patients with positive results of RT-PCR is higher than that in patients with negative results; and 5. The hospitalization duration for RT--PCR positive patients, which accounts for 4.87 days, is longer than that for RT-PCT negative patients(p=0.008). Overall, the H1N1 RT-PCR result is associated with asthma attack (p = 0.019).
Conclusions:
All in all, it is noted in this study that although the novel H1N1 influenza and seasonal influenza do not cause serious disease, asthma induced by influenza will increase the severity of illness and prolong hospitalization and the correlated medical expenditure is expected to increase as well. Therefore, it is important for policymakers to incorporate the prevention and healthcare for asthma and disease into the asthma care plan. In addition, policies beneficial to influenza prevention such as influenza vaccination should be included to this care plan. Furthermore, research and development of antiviral therapy should also be combined into public health policy.
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