Influence of Referral Pathway on Ebola Virus Disease Case-Fatality Rate and Effect of Survival Selection Bias

Autor: Frauke Rudolf, Mads Damkjær, Suzanne Lunding, Kenn Dornonville de la Cour, Alyssa Young, Tim Brooks, Tom Sesay, Alex P. Salam, Sharmistha Mishra, Merete Storgaard
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: Emerging Infectious Diseases, Vol 23, Iss 4, Pp 597-600 (2017)
Druh dokumentu: article
ISSN: 1080-6040
1080-6059
DOI: 10.3201/eid2304.160485
Popis: Case-fatality rates in Ebola treatment centers (ETCs) varied widely during the Ebola virus disease (EVD) outbreak in West Africa. We assessed the influence of referral pathway on ETC case-fatality rates with a retrospective cohort of 126 patients treated at the Mathaska ETC in Port Loko, Sierra Leone. The patients consisted of persons who had confirmed EVD when transferred to the ETC or who had been diagnosed onsite. The case-fatality rate for transferred patients was 46% versus 67% for patients diagnosed onsite (p = 0.02). The difference was mediated by Ebola viral load at diagnosis, suggesting a survival selection bias. Comparisons of case-fatality rates across ETCs and clinical management strategies should account for potential survival selection bias.
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