ArticlePloS one2014
Demographic and clinical predictors of mortality from highly pathogenic avian influenza A (H5N1) virus infection: CART analysis of international cases.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Global epidemiology of avian influenza A H5N1 virus infection in humans, 1997-2015: a systematic review of individual case data.The Lancet. Infectious diseases · 2016Pooled it
- The emergence of highly pathogenic avian influenza H5N1 in dairy cattle: implications for public health, animal health, and pandemic preparedness.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Review
- Are we cultivating the perfect storm for a human avian influenza pandemic?Biological research · 2024Review
- AMMI Canada 2023 update on influenza: Management and emerging issues.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2023Article
- Article
- Analysis of efficacy of intervention strategies for COVID-19 transmission: A case study of Hong Kong.Environment international · 2021Article
- Prognostic accuracy of SIRS criteria and qSOFA score for in-hospital mortality among influenza patients in the emergency department.BMC infectious diseases · 2020Article
- A clinical approach to the threat of emerging influenza viruses in the Asia-Pacific region.Respirology (Carlton, Vic.) · 2017Review
- Classification and Regression Tree (CART) analysis to predict influenza in primary care patients.BMC infectious diseases · 2016Article
- Chronological, geographical, and seasonal trends of human cases of avian influenza A (H5N1) in Vietnam, 2003-2014: a spatial analysis.BMC infectious diseases · 2016Article
- A viable recombinant rhabdovirus lacking its glycoprotein gene and expressing influenza virus hemagglutinin and neuraminidase is a potent influenza vaccine.Journal of virology · 2015Article
- Overview of the 3rd isirv-Antiviral Group Conference--advances in clinical management.Influenza and other respiratory viruses · 2015Review
- Understanding the cross-resistance of oseltamivir to H1N1 and H5N1 influenza A neuraminidase mutations using multidimensional computational analyses.Drug design, development and therapy · 2015Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundHuman infections with highly pathogenic avian influenza (HPAI) A (H5N1) viruses have occurred in 15 countries, with high mortality to date. Determining risk factors for morbidity and mortality from HPAI H5N1 can inform preventive and therapeutic interventions.
methodsWe included all cases of human HPAI H5N1 reported in World Health Organization Global Alert and Response updates and those identified through a systematic search of multiple databases (PubMed, Scopus, and Google Scholar), including articles in all languages. We abstracted predefined clinical and demographic predictors and mortality and used bivariate logistic regression analyses to examine the relationship of each candidate predictor with mortality. We developed and pruned a decision tree using nonparametric Classification and Regression Tree methods to create risk strata for mortality.
findingsWe identified 617 human cases of HPAI H5N1 occurring between December 1997 and April 2013. The median age of subjects was 18 years (interquartile range 6-29 years) and 54% were female. HPAI H5N1 case-fatality proportion was 59%. The final decision tree for mortality included age, country, per capita government health expenditure, and delay from symptom onset to hospitalization, with an area under the receiver operator characteristic (ROC) curve of 0.81 (95% CI: 0.76-0.86).
interpretationA model defined by four clinical and demographic predictors successfully estimated the probability of mortality from HPAI H5N1 illness. These parameters highlight the importance of early diagnosis and treatment and may enable early, targeted pharmaceutical therapy and supportive care for symptomatic patients with HPAI H5N1 virus infection.
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