Demanda de atención hospitalaria por gripe A/H1N1: evaluación de los primeros 1.000 casos atendidos / Hospital care of patients with A/H1N1 influenza: Evaluation of the first 1000 reported cases in Spain

Introducción y objetivos: A pesar del enorme impacto que se prevé tenga la pandemia por gripe A/H1N1 en países del hemisferio norte, todavía son escasos los datos disponibles de su repercusión a nivel hospitalario. El objetivo de este trabajo es evaluar la asistencia prestada a los pacientes atendidos por posible gripe A y su evolución en un hospital de tercer nivel.Material y método: Desde la aparición de los primeros casos se estableció un circuito específico de atención a pacientes con posible gripe A en la unidad de admisión, urgencias y hospitalización. Se diseñó un registro nominal con variables epidemiológicas y variables clínicas.Resultados: A 31 de agosto de 2009 se habían evaluado 1.018 pacientes por posible gripe A, de los que el 77% cumplía criterios clínicos. Entre los pacientes con sospecha de gripe A, la edad media (desviación estándar) fue de 31,71 (17,2) años, el 52% eran mujeres, un 3,3% de ellas embarazadas o puérperas. Ingresó el 23,4%, y la estancia media global fue de 3,5 días y de 2,5 días para los adultos que ingresaron en la unidad de corta estancia. Un 2,8% presentó neumonía y 2 pacientes necesitaron atención en unidad de cuidados intensivos (uno de ellos falleció).Conclusiones: Nuestra serie muestra una epidemia de gripe que se comporta de forma benigna con un porcentaje considerable de neumonías, pero que evolucionan favorablemente. A pesar del alto porcentaje de ingresos, y para evitar el menoscabo de la atención a otros enfermos, consideramos que un modelo asistencial basado en unidades específicas, estancias cortas y seguimiento posthospitalario puede ser adecuado (AU)

Introduction and objectives: Influenza A is expected to have a great impact in countries in the northern hemisphere yet little has been reported about how this outbreak can affect hospital care. The aim of this study is to assess patients who demand care for flu symptoms and their outcome. Material and methods: From the beginning of the outbreak a specific protocol was established for the care of patients with potential influenza A in admission, emergency and hospitalization ward. A nominal registry was designed with clinical and epidemiological data.Results: 1018 patients were evaluated for potential influenza A from the beginning of the outbreak until the 31st August, 2009. 77% of them fulfilled clinical criteria and were classified as suspected cases. Mean age was 31,7 years (SD17,2), 52% were women, 3,3% pregnant or puerperal. The admission rate was 23,4% with a global mean stay of 3,5 days, and 2,5 for the adults who were admitted to the short stay hospital unit. 2,8 % had pneumonia, two patients required admission to the intensive care unit and one of them died.Conclusions: Our data show an outbreak with mild illness, with a remarkable percentage of pneumonia but with good outcome. Despite of the high percentage of admissions, and in order to avoid the misleading attention to other patients, we believe that an assistance model based in specific units, short stay and post-discharge follow up could be suitable (AU)

[Hospital care of patients with A/H1N1 influenza: evaluation of the first 1000 reported cases in Spain]. / Demanda de atención hospitalaria por gripe A/H1N1: evaluación de los primeros 1.000 casos atendidos.

INTRODUCTION AND OBJECTIVES: Influenza A is expected to have a great impact in countries in the northern hemisphere yet little has been reported about how this outbreak can affect hospital care. The aim of this study is to assess patients who demand care for flu symptoms and their outcome. MATERIAL AND METHODS: From the beginning of the outbreak a specific protocol was established for the care of patients with potential influenza A in admission, emergency and hospitalization ward. A nominal registry was designed with clinical and epidemiological data. RESULTS: 1018 patients were evaluated for potential influenza A from the beginning of the outbreak until the 31(st) August, 2009. 77% of them fulfilled clinical criteria and were classified as suspected cases. Mean age was 31,7 years (SD17,2), 52% were women, 3,3% pregnant or puerperal. The admission rate was 23,4% with a global mean stay of 3,5 days, and 2,5 for the adults who were admitted to the short stay hospital unit. 2,8 % had pneumonia, two patients required admission to the intensive care unit and one of them died. CONCLUSIONS: Our data show an outbreak with mild illness, with a remarkable percentage of pneumonia but with good outcome. Despite of the high percentage of admissions, and in order to avoid the misleading attention to other patients, we believe that an assistance model based in specific units, short stay and post-discharge follow up could be suitable.