SpO2 on Admission as a Predictor of Outcome in Swine Flu Patients admitted to Government Medical College, Aurangabad (Maharashtra)

Background: Since 2009, Government Medical College, Aurangabad, which is a tertiary care hospital in the region, has been regularly admitting cases of pneumonia and ARDS, that are labeled as swine flu suspects, in the Isolation Ward. Those cases whose report tests positive for H1N1 are retained in the well equipped Ward, whereas the others are shifted to the general MICU or respective wards. This study correlates SpO2 on admission with the outcome in swine flu patients admitted to Government Medical College, Aurangabad from January 2015 to May -2015. Aims and Objectives: The primary objective was to correlate the SpO2 (Oxygen saturation) at admission with outcome –viz survival or death. Materials and Methods: 59 cases of swine flu confirmed by PCR were admitted in the swine flu ward from January 2015 to May -2015, of whom 24 died. All the cases who were admitted immediately underwent a thorough clinical examination, including SpO2. ABG, routine CBC, LFT, KFT, HIV testing (after counselling patient or close relative), X-Ray chest were done in all cases. Statistical analysis was done by SPSS, version 20. Results: A total of 59 PCR-confirmed H1N1-infected patients were included in the study. Of these 31 (53%) were males and 28 (47%) females. All the 8 (100%) HINI positive patients whose SpO2 immediately at the time of admission, while breathing room air, was< 60%, died. 7of the 9 (78%) HINI positive patients whose SpO2 at the time of admission was 61-75% also died. On the other hand, only 9 (21.4%) of the 42 HINI positive patients having SpO2 >76% died (p= 0.00000141) Conclusion: In H1N1 positive patients, the value of Sp02 at the time of admission by a simple device like pulse oximeter is a significant predictor of mortality. In our study it was observed that if the SpO2 measured immediately at admission was <60, the mortality was 100%, regardless of other factors. All the patients whose Sp02 at admission was 89% or more, survived (100%).In the nine cases in whom the SpO2 was 61-75%, only two (22.2 %) survived. These values are highly significant statistically (p= 0.00000141).