Delay in diagnosis of influenza A (H1N1)pdm09 virus infection in critically ill patients and impact on clinical outcome

Álvarez-Lerma, F.; Quintero, M.L.M.; Guía, C.; Iglesias, L.M.; Robles-Musso, E.; Revuelta, M.R.M.; Márquez, E.; Yébenes, J.C.; Martín, M.; Ruiz, J.M.Q.; González, I.; Cervelló, J.R.; Pomares, J.; Robles, J.C.; Herraez, J.C.B.; Hernández, D.; Mariño, A.L.B.; Andrés, N.H.; Díaz, J.J.; Padilla, A.; Garnacho-Montero, J.; Iglesia, R.; García-Rodríguez, Á.; Fernández, E.; Añón, J.M.; León, M.E.; Cilloniz, C.; Iniesta, R.S.; Marsilla, J.I.T.; Oyargue, E.Q.; Palacio, M.S.; Hinojosa, R.; Sala, C.; Sirvent,; Iglesias, L.; García, B.R.; López, O.; Escudero, R.Y.; Guerrero, R.; Ezpeleta, F.T.; García-López, F.; Regalado, L.; Messa, J.B.L.; Cárdenas, A.; Brea, A.M.P.; Crespo, M.R.; Marcos, R.J.; Arnau, E.; Catalán, R.M.; Rivero, J.C.; Rebolledo, J.P.; Pérez, M.L.C.; Lagunes, L.; Leria, M.R.; Sierra, R.; Ortiz, M.V.; Rodríguez-Carvajal, M.; Socias, A.; Marquina Lacueva, M.I.; Salamanca, Á.G.; Puncel, C.B.; Estrella, C.A.; Rodríguez, D.G.; Fernández, D.O.; Carbonero, J.A.M.; Cobo, P.; Prieto, J.F.; Romero, O.M.; Ule, D.C.; Bartolomé, B.J.; Ballesteros, J.L.; Ruiz-Santana, S.; Balanzó, X.; Berezo, J.Á.; Ferreras, Z.; Anzález, A.O.; Nolla, J.; Fernández, B.Q.; Serrano, E.P.; Ramírez, C.S.; Fernández, Y.; Rovira, A.; Barbadillo, S.; de Medrano, M.G.L.; Vallés, J.; Ferrer, M.; Castellanos, M.Á.D.; González, de Molina; Huertos, M.J.; Fernández, F.; Ansorregui, S.B.; Baeza, I.; Montón, J.M.; de Arellano, S.G.R.; Catalán, I.; Lander, A.; Masclans, J.R.; López, M.Á.G.; Crespo, C.M.; Ocaña, D.; Macías, S.; Alé, M.P.; Ibañes, P.G.; Polo, C.S.; álvarez-Lerma, F.; Martínez, S.; Laborda, C.; Borges-Sa, M.; Almirall, J.; Serón, C.; Lobato, F.; Simón, A.; López, S.G.; Fernández, S.R.; Lázaro, J.F.M.; Regil, P.D.; Martínez, P.; Alonso, Á.Á.; García, Á.; Nieto, M.; Hernández, H.M.; Fierro, J.; Aguilar, P.A.; Palacios, B.M.; Sisón, M.; Marín-Corral, J.; Loza, A.; Lomas, L.T.; Trujillo, A.; Mañéz, R.; Goytisolo, J.M.B.; Páez, Z.; Vázquez, A.; Luque, P.; Echeverri, S.O.; Vila, C.; Ballús, J.; Albofedo-Sánchez, J.; Socias, L.; Granada, R.M.; Andrés, C.J.; Martín Loeches, I.; Casas, J.F.M.; Suberviola, B.; González, C.P.; de Toro, I.L.; Navarrete, I.; Sánchez, I.; Páez, J.; Del Castillo, A.; Terrero, A.Á.; Güell, E.; Ayestarán, I.; Senoff, R.P.; Ortíz, M.; Martins, J.; Beryanaki, M.Z.; Albaya, A.; Marina, L.; Rodríguez, A.; Zirena, A.C.C.; Varela, J.B.; Pérez G., F.J.; Soler, G.S.; ávila, R.C.; Avellanas, M.L.; Cuadrado, M.M.; Cía, I.G.; León, C.; Arenzana, Á.; Pérez, M.; Díaz, E.; álvarez, H.A.H; Obregón, A.S.; Muñoz, C.; Checa, A.A.; Cabré, L.; Soria, L.V.; Lorente, L.; Sola, E.C.; Pàmies, C.V.; Leyba, C.O.; Carbayo, C.; Estella, Á.; Torres, A.; Rodríguez, M.C.M.; Laderas, J.C.P.; Gómez, A.B.; Martín-Loeches, I.; Souto, J.; Ugarte, P.; Grande, M.L.G.; Pueyo, M.J.L.; Schweizer, P.B.; Núñez, C.L.; Ibáñez, P.; de, la Torre; Cáceres, J.J.; Rello, J.; Canabal, A.

doi:10.1186/s13054-016-1512-1

000058441 001__ 58441
000058441 005__ 20220519113655.0
000058441 0247_ $$2doi$$a10.1186/s13054-016-1512-1
000058441 0248_ $$2sideral$$a97412
000058441 037__ $$aART-2016-97412
000058441 041__ $$aeng
000058441 100__ $$aÁlvarez-Lerma, F.
000058441 245__ $$aDelay in diagnosis of influenza A (H1N1)pdm09 virus infection in critically ill patients and impact on clinical outcome
000058441 260__ $$c2016
000058441 5060_ $$aAccess copy available to the general public$$fUnrestricted
000058441 5203_ $$aBackground: Patients infected with influenza A (H1N1)pdm09 virus requiring admission to the ICU remain an important source of mortality during the influenza season. The objective of the study was to assess the impact of a delay in diagnosis of community-acquired influenza A (H1N1)pdm09 virus infection on clinical outcome in critically ill patients admitted to the ICU. Methods: A prospective multicenter observational cohort study was based on data from the GETGAG/SEMICYUC registry (2009-2015) collected by 148 Spanish ICUs. All patients admitted to the ICU in which diagnosis of influenza A (H1N1)pdm09 virus infection had been established within the first week of hospitalization were included. Patients were classified into two groups according to the time at which the diagnosis was made: early (within the first 2 days of hospital admission) and late (between the 3rd and 7th day of hospital admission). Factors associated with a delay in diagnosis were assessed by logistic regression analysis. Results: In 2059 ICU patients diagnosed with influenza A (H1N1)pdm09 virus infection within the first 7 days of hospitalization, the diagnosis was established early in 1314 (63.8 %) patients and late in the remaining 745 (36.2 %). Independent variables related to a late diagnosis were: age (odds ratio (OR) = 1.02, 95 % confidence interval (CI) 1.01-1.03, P < 0.001); first seasonal period (2009-2012) (OR = 2.08, 95 % CI 1.64-2.63, P < 0.001); days of hospital stay before ICU admission (OR = 1.26, 95 % CI 1.17-1.35, P < 0.001); mechanical ventilation (OR = 1.58, 95 % CI 1.17-2.13, P = 0.002); and continuous venovenous hemofiltration (OR = 1.54, 95 % CI 1.08-2.18, P = 0.016). The intra-ICU mortality was significantly higher among patients with late diagnosis as compared with early diagnosis (26.9 % vs 17.1 %, P < 0.001). Diagnostic delay was one independent risk factor for mortality (OR = 1.36, 95 % CI 1.03-1.81, P < 0.001). Conclusions: Late diagnosis of community-acquired influenza A (H1N1)pdm09 virus infection is associated with a delay in ICU admission, greater possibilities of respiratory and renal failure, and higher mortality rate. Delay in diagnosis of flu is an independent variable related to death.
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000058441 590__ $$a5.358$$b2016
000058441 591__ $$aCRITICAL CARE MEDICINE$$b6 / 33 = 0.182$$c2016$$dQ1$$eT1
000058441 592__ $$a2.373$$b2016
000058441 593__ $$aCritical Care and Intensive Care Medicine$$c2016$$dQ1
000058441 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000058441 700__ $$aMarín-Corral, J.
000058441 700__ $$aVila, C.
000058441 700__ $$aMasclans, J.R.
000058441 700__ $$aGonzález, de Molina
000058441 700__ $$aMartín Loeches, I.
000058441 700__ $$aBarbadillo, S.
000058441 700__ $$aRodríguez, A.
000058441 700__ $$aCobo, P.
000058441 700__ $$aMartins, J.
000058441 700__ $$aCarbayo, C.
000058441 700__ $$aRobles-Musso, E.
000058441 700__ $$aCárdenas, A.
000058441 700__ $$aFierro, J.
000058441 700__ $$aFernández, D.O.
000058441 700__ $$aSierra, R.
000058441 700__ $$aHuertos, M.J.
000058441 700__ $$aPérez, M.L.C.
000058441 700__ $$aLaderas, J.C.P.
000058441 700__ $$aGuerrero, R.
000058441 700__ $$aRobles, J.C.
000058441 700__ $$aLeón, M.E.
000058441 700__ $$aGómez, A.B.
000058441 700__ $$aMárquez, E.
000058441 700__ $$aRodríguez-Carvajal, M.
000058441 700__ $$aEstella, Á.
000058441 700__ $$aPomares, J.
000058441 700__ $$aBallesteros, J.L.
000058441 700__ $$aRomero, O.M.
000058441 700__ $$aFernández, Y.
000058441 700__ $$aLobato, F.
000058441 700__ $$aPrieto, J.F.
000058441 700__ $$aAlbofedo-Sánchez, J.
000058441 700__ $$aMartínez, P.
000058441 700__ $$ade, la Torre
000058441 700__ $$aNieto, M.
000058441 700__ $$aSola, E.C.
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000058441 700__ $$aAlé, M.P.
000058441 700__ $$aBrea, A.M.P.
000058441 700__ $$aCasas, J.F.M.
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000058441 700__ $$aAvellanas, M.L.
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000058441 700__ $$aMarquina Lacueva, M.I.
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000058441 700__ $$aGoytisolo, J.M.B.
000058441 700__ $$aCarbonero, J.A.M.
000058441 700__ $$aAyestarán, I.
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000058441 700__ $$aPadilla, A.
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000058441 700__ $$aCanabal, A.
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000058441 700__ $$aPáez, Z.
000058441 700__ $$aGarcía, Á.
000058441 700__ $$aUle, D.C.
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000058441 700__ $$aRebolledo, J.P.
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000058441 700__ $$aBallús, J.
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000058441 700__ $$aAlmirall, J.
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000058441 700__ $$aGüell, E.
000058441 700__ $$aYébenes, J.C.
000058441 700__ $$aRello, J.
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000058441 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000058441 773__ $$g20, 1 (2016), 337 [11 pp.]$$pCrit. care$$tCritical care$$x1364-8535
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