tetano
Editor, Senior Moderator
Eur J Intern Med. 2019 Dec 31. pii: S0953-6205(19)30460-1. doi: 10.1016/j.ejim.2019.12.022. [Epub ahead of print] [h=1]Predictors of mortality of influenza virus infections in a Swiss Hospital during four influenza seasons: Role of quick sequential organ failure assessment.[/h]
Papadimitriou-Olivgeris M[SUP]1[/SUP], Gkikopoulos N[SUP]2[/SUP], W?st M[SUP]2[/SUP], Ballif A[SUP]2[/SUP], Simonin V[SUP]2[/SUP], Maulini M[SUP]2[/SUP], Nusbaumer C[SUP]3[/SUP], Bertaiola Monnerat L[SUP]3[/SUP], Tschopp J[SUP]4[/SUP], Kampouri EE[SUP]4[/SUP], Wilson P[SUP]2[/SUP], Duplain H[SUP]5[/SUP].
[h=3]Author information[/h] 1 Department of Internal Medicine, Hospital of Jura, Del?mont, Switzerland; Department of Infectious Diseases, University Hospital of Lausanne, Lausanne, Switzerland. Electronic address: Matthaios.Papadimitriou-Olivgeris@chuv.ch. 2 Department of Internal Medicine, Hospital of Jura, Del?mont, Switzerland. 3 Laboratory Department, Hospital of Jura, Del?mont, Switzerland. 4 Department of Infectious Diseases, University Hospital of Lausanne, Lausanne, Switzerland. 5 Department of Internal Medicine, Hospital of Jura, Del?mont, Switzerland; Faculty of biology and medicine, University of Lausanne, Lausanne, Switzerland.
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Influenza infections have been associated with high morbidity. The aims were to determine predictors of mortality among patients with influenza infections and to ascertain the role of quick Sequential Organ Failure Assessment (qSOFA) in predicting poor outcomes.
[h=4]METHODS:[/h] All adult patients with influenza infection at the Hospital of Jura, Switzerland during four influenza seasons (2014/15 to 2017/18) were included. Cepheid Xpert Xpress Flu/RSV was used during the first three influenza seasons and Cobas Influenza A/B and RSV during the 2017/18 season.
[h=4]RESULTS:[/h] Among 1684 influenza virus tests performed, 441 patients with influenza infections were included (238 for influenza A virus and 203 for B). The majority of infections were community onset (369; 83.7%). Thirty-day mortality was 6.0% (25 patients). Multivariate analysis revealed that infection due to A virus (P 0.035; OR 7.1; 95% CI 1.1-43.8), malnutrition (P < 0.001; OR 25.0; 95% CI 4.5-138.8), hospital-acquired infection (P 0.003; OR 12.2; 95% CI 2.3-65.1), respiratory insufficiency (PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] < 300) (P < 0.001; OR 125.8; 95% CI 9.6-1648.7) and pulmonary infiltrate on X-ray (P 0.020; OR 6.0; 95% CI 1.3-27.0) were identified as predictors of mortality. qSOFA showed a very good accuracy (0.89) equivalent to other more specific and burdensome scores such as CURB-65 and Pneumonia Severity Index (PSI).
[h=4]CONCLUSION:[/h] qSOFA performed similarly to specific severity scores (PSI, CURB-65) in predicting mortality. Infection by influenza A virus, respiratory insufficiency and malnutrition were associated with worse prognosis.
Copyright ? 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
[h=4]KEYWORDS:[/h] CURB-65; Influenza infection; Malnutrition; Pneumonia Severity Index (PSI); qSOFA
PMID: 31899057 DOI: 10.1016/j.ejim.2019.12.022
Papadimitriou-Olivgeris M[SUP]1[/SUP], Gkikopoulos N[SUP]2[/SUP], W?st M[SUP]2[/SUP], Ballif A[SUP]2[/SUP], Simonin V[SUP]2[/SUP], Maulini M[SUP]2[/SUP], Nusbaumer C[SUP]3[/SUP], Bertaiola Monnerat L[SUP]3[/SUP], Tschopp J[SUP]4[/SUP], Kampouri EE[SUP]4[/SUP], Wilson P[SUP]2[/SUP], Duplain H[SUP]5[/SUP].
[h=3]Author information[/h] 1 Department of Internal Medicine, Hospital of Jura, Del?mont, Switzerland; Department of Infectious Diseases, University Hospital of Lausanne, Lausanne, Switzerland. Electronic address: Matthaios.Papadimitriou-Olivgeris@chuv.ch. 2 Department of Internal Medicine, Hospital of Jura, Del?mont, Switzerland. 3 Laboratory Department, Hospital of Jura, Del?mont, Switzerland. 4 Department of Infectious Diseases, University Hospital of Lausanne, Lausanne, Switzerland. 5 Department of Internal Medicine, Hospital of Jura, Del?mont, Switzerland; Faculty of biology and medicine, University of Lausanne, Lausanne, Switzerland.
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Influenza infections have been associated with high morbidity. The aims were to determine predictors of mortality among patients with influenza infections and to ascertain the role of quick Sequential Organ Failure Assessment (qSOFA) in predicting poor outcomes.
[h=4]METHODS:[/h] All adult patients with influenza infection at the Hospital of Jura, Switzerland during four influenza seasons (2014/15 to 2017/18) were included. Cepheid Xpert Xpress Flu/RSV was used during the first three influenza seasons and Cobas Influenza A/B and RSV during the 2017/18 season.
[h=4]RESULTS:[/h] Among 1684 influenza virus tests performed, 441 patients with influenza infections were included (238 for influenza A virus and 203 for B). The majority of infections were community onset (369; 83.7%). Thirty-day mortality was 6.0% (25 patients). Multivariate analysis revealed that infection due to A virus (P 0.035; OR 7.1; 95% CI 1.1-43.8), malnutrition (P < 0.001; OR 25.0; 95% CI 4.5-138.8), hospital-acquired infection (P 0.003; OR 12.2; 95% CI 2.3-65.1), respiratory insufficiency (PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] < 300) (P < 0.001; OR 125.8; 95% CI 9.6-1648.7) and pulmonary infiltrate on X-ray (P 0.020; OR 6.0; 95% CI 1.3-27.0) were identified as predictors of mortality. qSOFA showed a very good accuracy (0.89) equivalent to other more specific and burdensome scores such as CURB-65 and Pneumonia Severity Index (PSI).
[h=4]CONCLUSION:[/h] qSOFA performed similarly to specific severity scores (PSI, CURB-65) in predicting mortality. Infection by influenza A virus, respiratory insufficiency and malnutrition were associated with worse prognosis.
Copyright ? 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
[h=4]KEYWORDS:[/h] CURB-65; Influenza infection; Malnutrition; Pneumonia Severity Index (PSI); qSOFA
PMID: 31899057 DOI: 10.1016/j.ejim.2019.12.022