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Flu-IV score: a predictive tool for assessing the risk of invasive mechanical ventilation in patients with influenza-related pneumonia
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  • Chen Liang,
  • xiudi Han,
  • Yanli Li,
  • Chunxiao Zhang,
  • Xiqian Xing
Chen Liang

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Chunxiao Zhang
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Xiqian Xing
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Aim: To develop an assessment tool to predict invasive mechanical ventilation (IMV) among influenza-related pneumonia (Flu-p) patients within 14 days of admission. Methods: In total, 1107 Flu-p patients from five teaching hospitals were retrospectively enrolled from January 2012 - December 2019 and used to develop a predictive model. Results: Overall, 10.6% (117/1107) of patients underwent IMV within 14 days of admission. Multivariate regression analyses revealed that the following factors were associated with IMV: early neuraminidase inhibitor use (-2 points), lymphocytes < 0.8×109/L (1 points), multi-lobar infiltrates (1 point), age ≥ 65 years old (2 points), systemic corticosteroid use (2 points), PaO2/FiO2 < 300 mmHg (2 points), respiratory rate ≥ 30 breaths/min (3 points), and arterial PH < 7.35 (3 points). A total score of six points was used to identify patients at risk of IMV. This model had a sensitivity of 88.79%, a specificity of 87.55%, and exhibited better predictive performance than the ROX index (AUROC = 0.927 vs 0.688, p < 0.001), modified ROX index (AUROC = 0.927 vs 0.747, p < 0.001), and HACOR scale (AUROC = 0.927 vs 0.524, p < 0.001). Conclusions: Flu-IV scores can be used to reliably predict 14-day IMV rates in Flu-p patients.