Management of hospitalized influenza A patients during the season 2018/19 : Comparison of three medical departments and the effect on outcome and antibiotic usage.
Wien Klin Wochenschr
; 133(23-24): 1310-1317, 2021 Dec.
Article
in English
| MEDLINE | ID: covidwho-1756806
ABSTRACT
BACKGROUND:
Diagnosis and treatment of influenza patients are often provided across several medical specialties. We compared patient outcomes at an infectious diseases (ID), a rheumatology (Rheu) and a pulmonology (Pul) department. MATERIAL ANDMETHODS:
In this prospective observational multicenter study we included all influenza positive adults who were hospitalized and treated at flu isolation wards in three hospitals in Vienna during the season 2018/2019.RESULTS:
A total of 490 patients (49% female) with a median age of 73 years (interquartile range [IQR] 61-82) were included. No differences regarding age, sex and most underlying diseases were present at admission. Frequencies of the most common complications differed acute kidney failure (ID 12.7%, Rheu 21.2%, Pulm 37.1%, pâ¯< 0.001), acute heart failure (ID 4.3%, Rheu 17.1%, Pulm 14.4%, pâ¯< 0.001) and respiratory insufficiency (ID 45.1%, Rheu 41.5%, Pulm 56.3%, pâ¯= 0.030). Oseltamivir prescription was lowest at the pulmonology flu ward (ID 79.6%, Rheu 90.5%, Pulm 61.7%, pâ¯< 0.001). In total 176 patients (35.9%) developed pneumonia. Antibiotic selection varied between the departments amoxicillin/clavulanic acid (ID 28.9%, Rheu 63.8%, Pulm 5.9%, pâ¯< 0.001), cefuroxime (ID 28.9%, Rheu 1.3%, Pulm 0%, pâ¯< 0.001), 3rd generation cephalosporins (ID 4.4%, Rheu 5%, Pulm 72.5%, pâ¯< 0.001), doxycycline (ID 17.8%, Rheu 0%, Pulm 0%, pâ¯< 0.001). The median length of stay was significantly different between wards ID 6 days (IQR 5-8), Rheu 6 days (IQR 5-7) and Pulm 7 days (IQR 5-9.5, pâ¯= 0.034). In-hospital mortality was 4.3% and did not differ between specialties.CONCLUSION:
We detected differences in oseltamivir usage, length of in-hospital stay and antibiotic choices for pneumonia. Influenza-associated mortality was unaffected by specialty.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Influenza, Human
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Wien Klin Wochenschr
Year:
2021
Document Type:
Article
Affiliation country:
S00508-021-01950-8
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