dc.contributor |
Universitat de Barcelona |
dc.contributor.author |
Álvarez Lerma, Francisco |
dc.contributor.author |
Marín Corral, Judith |
dc.contributor.author |
Vila, Clara |
dc.contributor.author |
Masclans, Joan Ramón |
dc.contributor.author |
González de Molina, Francisco Javier |
dc.contributor.author |
Martín Loeches, Ignacio |
dc.contributor.author |
Barbadillo, Sandra |
dc.contributor.author |
Rodríguez, Alejandro |
dc.contributor.author |
Torres Martí, Antoni |
dc.contributor.author |
Cillóniz, Catia |
dc.contributor.author |
H1N1 GETGAG/SEMICYUC Study Group |
dc.date |
2019-11-12T12:22:41Z |
dc.date |
2019-11-12T12:22:41Z |
dc.date |
2016-10-23 |
dc.date |
2019-11-12T12:22:41Z |
dc.identifier.citation |
1364-8535 |
dc.identifier.citation |
673765 |
dc.identifier.citation |
5635420 |
dc.identifier.uri |
http://hdl.handle.net/2445/144573 |
dc.format |
application/pdf |
dc.language.iso |
eng |
dc.publisher |
BioMed Central |
dc.relation |
Reproducció del document publicat a: https://doi.org/10.1186/s13054-016-1512-1 |
dc.relation |
Critical Care, 2016, vol. 20 |
dc.relation |
https://doi.org/10.1186/s13054-016-1512-1 |
dc.rights |
cc-by (c) Álvarez Lerma, Francisco et al., 2016 |
dc.rights |
info:eu-repo/semantics/openAccess |
dc.rights |
http://creativecommons.org/licenses/by/3.0/es |
dc.subject |
Influenzavirus |
dc.subject |
Diagnòstic |
dc.subject |
Influenza viruses |
dc.subject |
Diagnosis |
dc.title |
Delay in diagnosis of influenza A (H1N1)pdm09 virus infection in critically ill patients and impact on clinical outcome |
dc.type |
info:eu-repo/semantics/article |
dc.type |
info:eu-repo/semantics/publishedVersion |
dc.description.abstract |
Background: 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. |