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

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

doi:10.1186/s13054-016-1512-1

000058441 001__ 58441
000058441 005__ 20170114133551.0
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 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.
000058441 700__ $$aCastellanos, M. Á. D.
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000058441 700__ $$aGarnacho-Montero, J.
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000058441 700__ $$aFernández, E.
000058441 700__ $$aLoza, A.
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000058441 700__ $$aLópez, S. G.
000058441 700__ $$aArenzana, Á.
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000058441 700__ $$aNavarrete, I.
000058441 700__ $$aBeryanaki, M. Z.
000058441 700__ $$aSánchez, I.
000058441 700__ $$aAlé, M. P.
000058441 700__ $$aBrea, A. M. P.
000058441 700__ $$aCasas, J. F. M.
000058441 700__ $$aSeron Arbeloa, Carlos$$uUniversidad de Zaragoza
000058441 700__ $$aAvellanas, M. L.
000058441 700__ $$aLander, A.
000058441 700__ $$ade Arellano, S. G. R.
000058441 700__ $$aMarquina Lacueva, M. I.
000058441 700__ $$aLuque, P.
000058441 700__ $$aSerrano, E. P.
000058441 700__ $$aLázaro, J. F. M.
000058441 700__ $$aPolo, C. S.
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000058441 700__ $$aBartolomé, B. J.
000058441 700__ $$aNúñez, C. L.
000058441 700__ $$aGonzález, I.
000058441 700__ $$aMarsilla, J. I. T.
000058441 700__ $$aAndrés, C. J.
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000058441 700__ $$aAguilar, P. A.
000058441 700__ $$0(orcid)0000-0003-4331-6956$$aMonton Dito, Jose María
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000058441 700__ $$aFernández, B. Q.
000058441 700__ $$aIglesias, L. M.
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000058441 700__ $$aGoytisolo, J. M. B.
000058441 700__ $$aCarbonero, J. A. M.
000058441 700__ $$aAyestarán, I.
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000058441 700__ $$aRegalado, L.
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000058441 700__ $$aLorente, L.
000058441 700__ $$aRivero, J. C.
000058441 700__ $$aQuintero, M. L. M.
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000058441 700__ $$aCáceres, J. J.
000058441 700__ $$aPalacio, M. S.
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000058441 700__ $$aLeria, M. R.
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000058441 700__ $$aGarcía-López, F.
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000058441 700__ $$aálvarez, H. A. -H
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000058441 700__ $$aHernández, H. M.
000058441 700__ $$aAlbaya, A.
000058441 700__ $$aObregón, A. S.
000058441 700__ $$aCrespo, C. M.
000058441 700__ $$aEstrella, C. A.
000058441 700__ $$aPuncel, C. B.
000058441 700__ $$aOyargue, E. Q.
000058441 700__ $$aCanabal, A.
000058441 700__ $$aMarina, L.
000058441 700__ $$ade Toro, I. L.
000058441 700__ $$aSimón, A.
000058441 700__ $$aAñón, J. M.
000058441 700__ $$aPueyo, M. J. L.
000058441 700__ $$aOrtiz, M. V.
000058441 700__ $$aEcheverri, S. O.
000058441 700__ $$aFerreras, Z.
000058441 700__ $$aHerraez, J. C. B.
000058441 700__ $$aMacías, S.
000058441 700__ $$aBerezo, J. Á.
000058441 700__ $$aVarela, J. B.
000058441 700__ $$aSchweizer, P. B.
000058441 700__ $$aSalamanca, Á. G.
000058441 700__ $$aLomas, L. T.
000058441 700__ $$aAnzález, A. O.
000058441 700__ $$aávila, R. C.
000058441 700__ $$aPérez G., F. J.
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000058441 700__ $$aGarcía, Á.
000058441 700__ $$aUle, D. C.
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000058441 700__ $$aRebolledo, J. P.
000058441 700__ $$aAndrés, N. H.
000058441 700__ $$aZirena, A. C. C.
000058441 700__ $$aGarcía, B. R.
000058441 700__ $$aMessa, J. B. L.
000058441 700__ $$aCatalán, R. M.
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000058441 700__ $$aTorres, A.
000058441 700__ $$aCilloniz, C.
000058441 700__ $$aAnsorregui, S. B.
000058441 700__ $$aCabré, L.
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000058441 700__ $$aNolla, J.
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000058441 700__ $$aMañéz, R.
000058441 700__ $$aBallús, J.
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000058441 700__ $$aRello, J.
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000058441 700__ $$aSirvent,
000058441 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDepartamento de Medicina, Psiquiatría y Dermatología$$cMedicina
000058441 773__ $$g20, 1 (2016), 337 [11 pp.]$$pCrit. care$$tCRITICAL CARE$$x1364-8535
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000058441 951__ $$a2017-01-13-15:07:52
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