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\begin{document}

\title{Associations between severe influenza-complicated thromboembolism
events, intensive care unit stays and mortality, and associated risk
factors: a retrospective cohort study}



\author[1]{WEI CHUN LEE}%
\author[1]{Che-Chia  Chang}%
\author[1]{Meng-Chin  Ho}%
\author[2]{Chin-Kuo LIN}%
\author[1]{Chieh-Mo  Lin}%
\author[2]{Yu-Hung Fang}%
\author[1]{Shu-Yi  Huang}%
\author[1]{Yu-Ching  Lin}%
\author[2]{Min-Chun Chuang}%
\author[1]{Tsung-Ming  Yang}%
\author[1]{Ming-Szu  Hung}%
\author[1]{Yen-Li Chou}%
\author[3]{Ying-Huang Tsai}%
\author[4]{Meng-Jer Hsieh}%
\affil[1]{Chang Gung Memorial Hospital Chiayi Branch}%
\affil[2]{Chiayi Chang Gung Memorial Hospital}%
\affil[3]{Chang-Gung Memorial Hospital, Kaohsiung}%
\affil[4]{Chang Gung Memorial Hospital Linkou}%


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  \date{June 14, 2024}


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\begin{abstract}
Background: Compelling evidence suggests associations between influenza
infection and thromboembolism (TE) events. Risk factors related to the
outcomes of severe influenza-complicated TE in intensive care unit (ICU)
patients remain unknown. Methods: A retrospective cohort study was
conducted, recruiting consecutive patients with thromboembolism (TE)
events admitted to the intensive care unit (ICU) between December 2015
through December 2018 at our institution in Taiwan. A study cohort of
patients with severe influenza (n=108) and a control group of patients
with severe community-acquired pneumonia (n=192) were included.
Associations between complicated TE, length of ICU stay, 90-day
mortality were evaluated. Results: Thromboembolism events prevalence was
significantly higher in ICU patients with severe influenza than in ICU
patients with severe CAP (21.3\% vs. 5.7\%, respectively;
p\textless{}0.05). The ratio of mechanical ventilation use, length of
mechanical ventilation use, ICU stay and 90-day mortality increased
significantly in ICU patients with severe influenza after developing TE
compared with patients without TE (all p\textless{}0.05). Influenza
infection and hypertension are the risk factors for thromboembolic
events in patients with severe influenza (p\textless{} 0.05). Besides,
complicated TE and severity of APACHE II score are risk factors for
90-day mortality in ICU patients with severe influenza (p\textless{}
0.05). Conclusions: ICU patients with severe influenza and complicated
TE have an increased risk of extended ICU stay and 90-day mortality
compared to patients with severe CAP. Risk is significantly increased in
patients with higher APACHE II score. this study may help define better
strategies for early recognition and prevention of severe
influenza-complicated TE.%
\end{abstract}%



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