J Infect Dis
. 2020 Nov 5;jiaa690.
doi: 10.1093/infdis/jiaa690. Online ahead of print.
Point-of-care influenza testing impacts clinical decision, patient flow and length of stay in hospitalized adults
E B Fjelltveit 1 2 3 , R J Cox 1 4 , J ?stensj? 5 , B Blomberg 2 6 , M H Ebbesen 4 , N Langeland 2 6 7 5 , K G-I Mohn 1 3
Affiliations
- PMID: 33151320
- DOI: 10.1093/infdis/jiaa690
Abstract
Background: Influenza is difficult to distinguish clinically from other acute respiratory infections. Rapid laboratory diagnosis can help initiate early effective antiviral treatment and isolation.
Aim: Implementing a novel point-of-care test (POCT) for influenza in the emergency department (ED) could improve treatment and isolation strategies and reduce the length-of-stay (LOS).
Methods: In a prospective, controlled observational cohort study, we enrolled patients admitted due to acute respiratory illness to two public hospitals in Bergen, Norway, one using a rapid POCT for influenza (n=400), the other (n=167) using conventional rapid lab-based assay.
Results: The prevalence of influenza was similar in the two hospitals (154/400, 38% versus 38%, 63/167, p=0.863), and most patients in both hospitals received antiviral (83% versus 81%,p=0.703) and antibiotic treatment (76% versus 73%, p= 0.469). Isolation was more often initiated in the ED in the hospital using POCT (91% versus 80%, p=0.025). Diagnosis by POCT was associated with shorter hospital stay, while old age, diabetes, cancer, use of antibiotics, particularly broad-spectrum antibiotics, were associated with prolonged stay.
Conclusions: POCT implementation in the ED resulted in improved targeted isolation and shorter LOS. Regardless of POCT-use, most influenza patients received antivirals (>80%) and antibiotics (>70%).
Keywords: Influenza; antibiotics; hospitalized adults; isolation; length-of-stay; molecular assay; neuraminidase inhibitor; point-of-care test.