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Emerg Med J. 2013 Feb 28. [Epub ahead of print]
Predictive factors of severe multilobar pneumonia and shock in patients with influenza.
Garcia Gutierrez S, Quintana JM, Baricot M, Bilbao A, Capelastegui A, Cilla Eguiluz CG, Dom?nguez A, Castilla J, Godoy P, Delgado-Rodr?guez M, Soldevila N, Astray J, Mayoral JM, Mart?n V, Gonz?lez-Candelas F, Gal?n JC, Tamames S, Castro-Acosta AA, Gar?n O, Pumarola T; the CIBERESP Cases and Controls in Pandemic Influenza Working Group, Spain.
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Unidad de Investigaci?n, Red de Investigaci?n en Servicios de Salud en Enfermedades Cr?nicas (REDISSEC), Hospital Galdakao-Usansolo (Osakidetza), Galdakao, Bizkaia, Spain.
Abstract
PURPOSE:
To identify risk factors present at admission in adult patients hospitalised due to influenza virus infection during the 2009/10 and 2010/11 seasons-including whether infection was from pandemic or seasonal influenza A infections-that were associated with the likelihood of developing severe pneumonia with multilobar involvement and shock.
METHODS:
Prospective cohort study. Patients hospitalised due to influenza virus infection were recruited. We collected information on sociodemographic characteristics, pre-existing medical conditions, vaccinations, toxic habits, previous medications, exposure to social environments, and EuroQoL-5D (EQ-5D). Severe pneumonia with multilobar involvement and/or shock (SPAS) was the primary outcome of interest. We constructed two multivariate logistic regression models to explain the likelihood of developing SPAS and to create a clinical prediction rule for developing SPAS that includes clinically relevant variables.
RESULTS:
Laboratory-confirmed A(H1N1)pdm09, EQ-5D utility score 7 days before admission, more than one comorbidity, altered mental status, dyspnoea on arrival, days from onset of symptoms, and influenza season were associated with SPAS. In addition, not being vaccinated against seasonal influenza in the previous year, anaemia, altered mental status, fever and dyspnoea on arrival at hospital, difficulties in performing activities of daily living in the previous 7 days, and days from onset of symptoms to arrival at hospital were related to the likelihood of SPAS (area under the curve value of 0.75; Hosmer-Lemeshow p value of 0.84).
CONCLUSIONS:
These variables should be taken into account by physicians evaluating a patient affected by influenza as additional information to that provided by the usual risk scores.
PMID:
23449891
[PubMed - as supplied by publisher]
Predictive factors of severe multilobar pneumonia and shock in patients with influenza.
Garcia Gutierrez S, Quintana JM, Baricot M, Bilbao A, Capelastegui A, Cilla Eguiluz CG, Dom?nguez A, Castilla J, Godoy P, Delgado-Rodr?guez M, Soldevila N, Astray J, Mayoral JM, Mart?n V, Gonz?lez-Candelas F, Gal?n JC, Tamames S, Castro-Acosta AA, Gar?n O, Pumarola T; the CIBERESP Cases and Controls in Pandemic Influenza Working Group, Spain.
The following toggler user interface control may not be accessible. Tab to the next button to revert the control to an accessible version.
Destroy user interface controlCollaborators (121)
Source
Unidad de Investigaci?n, Red de Investigaci?n en Servicios de Salud en Enfermedades Cr?nicas (REDISSEC), Hospital Galdakao-Usansolo (Osakidetza), Galdakao, Bizkaia, Spain.
Abstract
PURPOSE:
To identify risk factors present at admission in adult patients hospitalised due to influenza virus infection during the 2009/10 and 2010/11 seasons-including whether infection was from pandemic or seasonal influenza A infections-that were associated with the likelihood of developing severe pneumonia with multilobar involvement and shock.
METHODS:
Prospective cohort study. Patients hospitalised due to influenza virus infection were recruited. We collected information on sociodemographic characteristics, pre-existing medical conditions, vaccinations, toxic habits, previous medications, exposure to social environments, and EuroQoL-5D (EQ-5D). Severe pneumonia with multilobar involvement and/or shock (SPAS) was the primary outcome of interest. We constructed two multivariate logistic regression models to explain the likelihood of developing SPAS and to create a clinical prediction rule for developing SPAS that includes clinically relevant variables.
RESULTS:
Laboratory-confirmed A(H1N1)pdm09, EQ-5D utility score 7 days before admission, more than one comorbidity, altered mental status, dyspnoea on arrival, days from onset of symptoms, and influenza season were associated with SPAS. In addition, not being vaccinated against seasonal influenza in the previous year, anaemia, altered mental status, fever and dyspnoea on arrival at hospital, difficulties in performing activities of daily living in the previous 7 days, and days from onset of symptoms to arrival at hospital were related to the likelihood of SPAS (area under the curve value of 0.75; Hosmer-Lemeshow p value of 0.84).
CONCLUSIONS:
These variables should be taken into account by physicians evaluating a patient affected by influenza as additional information to that provided by the usual risk scores.
PMID:
23449891
[PubMed - as supplied by publisher]
