Epidemiological and clinical characteristics of community‐acquired and nosocomial influenza cases and risk factors associated with complications: A four season analysis of all adult patients admitted in a tertiary hospital
| Autor: | Maria del Carmen Lopez Bilbao, Melchor Riera Jaume, Javier Asensio Rodriguez, Pilar Sanchis Cortés, Maria Almodovar Garcia, Francisca Artigues Serra, Pilar Salva D’agosto, Maria Isabel Fullana Barceló, Jorge Reina Prieto, Adrian Ferre Beltran |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Pulmonary and Respiratory Medicine medicine.medical_specialty Oseltamivir complications Epidemiology medicine.medical_treatment hospital‐ law.invention Tertiary Care Centers chemistry.chemical_compound Risk Factors law Internal medicine Influenza Human Humans Medicine Retrospective Studies Mechanical ventilation Cross Infection business.industry Septic shock Public Health Environmental and Occupational Health virus diseases hospital‐acquired influenza Original Articles medicine.disease Intensive care unit community‐acquired influenza acquired influenza Vaccination Infectious Diseases chemistry Original Article Observational study Seasons business Complication community‐ |
| Zdroj: | Influenza and Other Respiratory Viruses |
| ISSN: | 1750-2659 1750-2640 |
| DOI: | 10.1111/irv.12823 |
| Popis: | Background Information on the characteristics of patients with nosocomial influenza and associated complications is scarce. This study compared epidemiological and clinical characteristics of patients admitted with hospital‐acquired influenza (HAI) to those with community‐acquired influenza (CAI) and analyzed risk factors associated with complications. Methods This retrospective, observational study included all adult patients with confirmed influenza virus infection admitted to Son Espases University Hospital during the influenza season in Spain (October to May) from 2012‐2013 to 2015‐2016. Symptom onset before admission was included as CAI, and 2 days after admission or within 48 hours after previous discharge were considered as HAI. Results Overall, 666 patients with laboratory‐confirmed influenza were included; 590 (88.6%) and 76 (11.4%) had CAI and HAI, respectively. Baseline characteristics and vaccination rates were similar in both groups. Patients with HAI had significantly fewer symptoms, less radiological alterations, and earlier microbiological diagnosis than those with CAI. Eighty‐five (14.4%) and 20 (27.6%) CAI and HAI patients, respectively, experienced at least one complication, including septic shock, admission to the intensive care unit, mechanical ventilation or evolution to death (any one, P = .003). Univariate and multivariate binary logistic regression was performed to assess independent risk factors associated with the occurrence of complications: nosocomial infection, diabetes, oseltamivir treatment, having received no vaccination, microbiological delay, dyspnea, and the state of confusion were the most important significant factors. Conclusions Our study shows the need to implement microbiological diagnostic measures in the first 48 hours to reduce HAI frequency and associated complications. |
| Databáze: | OpenAIRE |
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