Delay in diagnosis of influenza A (H1N1)pdm09 virus infection in critically ill patients and impact on clinical outcome
Álvarez-Lerma, F. ; Marín-Corral, J. ; Vila, C. ; Masclans, J. R. ; González, de Molina ; Martín Loeches, I. ; Barbadillo, S. ; Rodríguez, A. ; Cobo, P. ; Martins, J. ; Carbayo, C. ; Robles-Musso, E. ; Cárdenas, A. ; Fierro, J. ; Fernández, D. O. ; Sierra, R. ; Huertos, M. J. ; Pérez, M. L. C. ; Laderas, J. C. P. ; Guerrero, R. ; Robles, J. C. ; León, M. E. ; Gómez, A. B. ; Márquez, E. ; Rodríguez-Carvajal, M. ; Estella, Á. ; Pomares, J. ; Ballesteros, J. L. ; Romero, O. M. ; Fernández, Y. ; Lobato, F. ; Prieto, J. F. ; Albofedo-Sánchez, J. ; Martínez, P. ; de, la Torre ; Nieto, M. ; Sola, E. C. ; Castellanos, M. Á. D. ; Soler, G. S. ; Leyba, C. O. ; Garnacho-Montero, J. ; Hinojosa, R. ; Fernández, E. ; Loza, A. ; León, C. ; López, S. G. ; Arenzana, Á. ; Ocaña, D. ; Navarrete, I. ; Beryanaki, M. Z. ; Sánchez, I. ; Alé, M. P. ; Brea, A. M. P. ; Casas, J. F. M. ; Seron Arbeloa, Carlos (Universidad de Zaragoza) ; Avellanas, M. L. ; Lander, A. ; de Arellano, S. G. R. ; Marquina Lacueva, M. I. ; Luque, P. ; Serrano, E. P. ; Lázaro, J. F. M. ; Polo, C. S. ; Cía, I. G. ; Bartolomé, B. J. ; Núñez, C. L. ; González, I. ; Marsilla, J. I. T. ; Andrés, C. J. ; Ibañes, P. G. ; Aguilar, P. A. ; Monton Dito, Jose María ; Regil, P. D. ; Iglesias, L. ; González, C. P. ; Fernández, B. Q. ; Iglesias, L. M. ; Soria, L. V. ; Escudero, R. Y. ; Revuelta, M. R. M. ; Ruiz, J. M. Q. ; García-Rodríguez, Á. ; Cuadrado, M. M. ; Mariño, A. L. B. ; Socias, L. ; Ibáñez, P. ; Borges-Sa, M. ; Socias, A. ; Del Castillo, A. ; Marcos, R. J. ; Muñoz, C. ; Goytisolo, J. M. B. ; Carbonero, J. A. M. ; Ayestarán, I. ; López, M. Á. G. ; Pàmies, C. V. ; Senoff, R. P. ; de Medrano, M. G. L. ; Ruiz-Santana, S. ; Díaz, J. J. ; Ramírez, C. S. ; Sisón, M. ; Hernández, D. ; Trujillo, A. ; Regalado, L. ; Fernández, S. R. ; Lorente, L. ; Rivero, J. C. ; Quintero, M. L. M. ; Martín, M. ; Martínez, S. ; Cáceres, J. J. ; Palacio, M. S. ; Rodríguez, D. G. ; Leria, M. R. ; Suberviola, B. ; Ugarte, P. ; García-López, F. ; Iniesta, R. S. ; Alonso, Á. Á. ; Padilla, A. ; Palacios, B. M. ; Grande, M. L. G. ; Rodríguez, M. C. M. ; álvarez, H. A. -H ; Checa, A. A. ; Hernández, H. M. ; Albaya, A. ; Obregón, A. S. ; Crespo, C. M. ; Estrella, C. A. ; Puncel, C. B. ; Oyargue, E. Q. ; Canabal, A. ; Marina, L. ; de Toro, I. L. ; Simón, A. ; Añón, J. M. ; Pueyo, M. J. L. ; Ortiz, M. V. ; Echeverri, S. O. ; Ferreras, Z. ; Herraez, J. C. B. ; Macías, S. ; Berezo, J. Á. ; Varela, J. B. ; Schweizer, P. B. ; Salamanca, Á. G. ; Lomas, L. T. ; Anzález, A. O. ; ávila, R. C. ; Pérez G., F. J. ; Terrero, A. Á. ; Ezpeleta, F. T. ; Sala, C. ; López, O. ; Páez, Z. ; García, Á. ; Ule, D. C. ; Crespo, M. R. ; Rebolledo, J. P. ; Andrés, N. H. ; Zirena, A. C. C. ; García, B. R. ; Messa, J. B. L. ; Catalán, R. M. ; Ferrer, M. ; Torres, A. ; Cilloniz, C. ; Ansorregui, S. B. ; Cabré, L. ; Baeza, I. ; Rovira, A. ; álvarez-Lerma, F. ; Vázquez, A. ; Nolla, J. ; Fernández, F. ; Cervelló, J. R. ; Iglesia, R. ; Mañéz, R. ; Ballús, J. ; Granada, R. M. ; Vallés, J. ; Díaz, E. ; Ortíz, M. ; Guía, C. ; Martín-Loeches, I. ; Páez, J. ; Almirall, J. ; Balanzó, X. ; Güell, E. ; Yébenes, J. C. ; Rello, J. ; Arnau, E. ; Pérez, M. ; Laborda, C. ; Souto, J. ; Lagunes, L. ; Catalán, I. ; Sirvent,
Resumen: 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.
Idioma: Inglés
DOI: 10.1186/s13054-016-1512-1
Año: 2016
Publicado en: CRITICAL CARE 20, 1 (2016), 337 [11 pp.]
ISSN: 1364-8535
Tipo y forma: Article (Published version)
Área (Departamento): Medicina (Departamento de Medicina, Psiquiatría y Dermatología)
0
Exportado de SIDERAL (2017-01-13-15:07:52)
Idioma: Inglés
DOI: 10.1186/s13054-016-1512-1
Año: 2016
Publicado en: CRITICAL CARE 20, 1 (2016), 337 [11 pp.]
ISSN: 1364-8535
Tipo y forma: Article (Published version)
Área (Departamento): Medicina (Departamento de Medicina, Psiquiatría y Dermatología)
0
Exportado de SIDERAL (2017-01-13-15:07:52)
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articulos > articulos-por-area > medicina
Notice créée le 2017-01-13, modifiée le 2017-01-14
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