Predictive factors of severe multilobar pneumonia and shock in patients with influenza

Susana Garcia Gutierrez, José Maria Quintana, Maretva Baricot, Amaia Bilbao, Alberto Capelastegui, Carlos Gustavo Cilla Eguiluz, Angela Domínguez, Jesús Castilla, Pere Godoy, Miguel Delgado-Rodríguez, Nuŕia Soldevila, Jenaro Astray, José María Mayoral, Vicente Martiń, Fernando Gonzaĺez-Candelas, Juan Carlos Galań, Sonia Tamames, Ady Angeĺica Castro-Acosta, Olatz Gariń, Tomaś Pumarola & 121 others M. A. Bueno, M. L. Gómez, M. Mariscal, B. Martínez, J. P. Quesada, M. Sillero, M. Carnero, J. Fernández-Crehuet, J. Del Diego Salas, V. Fuentes, V. Gallardo, E. Pérez, R. López, J. R. Maldonado, A. Morillo, I. Pedrosa Corral, M. F. Bautista, J. M. Navarro, M. Pérez, S. Oña, M. J. Pérez, M. C. Ubago, M. Zarzuela, P. Sanz, D. Carriedo, F. Díez, I. Fernández, S. Fernández, M. P. Sanz, J. J. Castrodeza, A. Pérez, R. De Ortiz Lejarazu, J. Ortiz, A. Pueyo, J. L. Viejo, A. Seco, P. Redondo, A. Molina, A. Agustí, A. Torres, A. Trilla, A. Vilella, F. Barbé, L. Blanch, G. Navarro, X. Bonfill, J. López-Contreras, V. Pomar, M. T. Puig, E. Borràs, A. Martínez, N. Torner, C. Bravo, F. Moraga, F. Calafell, J. Caylà, C. Tortajada, I. Garcia, J. Ruiz, J. J. García, J. Alonso, J. Gea, J. P. Horcajada, N. Hayes, A. Rosell, J. Dorca, Marc Saez, C. Álvarez, M. Enríquez, F. Pozo, F. Baquero, R. Cantón, A. Robustillo, M. Valdeón, E. Córdoba, F. Domínguez, J. García, R. Génova, E. Gil, S. Jiménez, M. A. Lopaz, J. López, F. Martín, M. L. Martínez, M. Ordobás, E. Rodriguez, S. Sánchez, C. Valdés, J. R. Paño, M. Romero, A. Martínez, L. Martínez, M. Ruiz, P. Fanlo, F. Gil, V. Martínez-Artola, J. M. Quintana, U. Aguirre, P. P. España, S. García, J. M. Antoñana, I. Astigarraga, J. I. Pijoan, I. Pocheville, M. Santiago, J. I. Villate, J. Arístegui, A. Escobar, M. I. Garrote, A. Bilbao, C. Garaizar, J. Korta, E. Pérez-Trallero, C. Sarasqueta, F. Aizpuru, J. L. Lobo, C. Salado, J. Alustiza, F. J. Troya, J. Blanquer, M. Morales

Research output: Contribution to journalArticle

Abstract

Purpose: To identify risk factors present at admission in adult patients hospitalised due to influenza virus infection during the 2009/10 and 2010/11 seasons - including whether infection was from pandemic or seasonal influenza A infections - that were associated with the likelihood of developing severe pneumonia with multilobar involvement and shock. Methods: Prospective cohort study. Patients hospitalised due to influenza virus infection were recruited. We collected information on sociodemographic characteristics, pre-existing medical conditions, vaccinations, toxic habits, previous medications, exposure to social environments, and EuroQoL-5D (EQ-5D). Severe pneumonia with multilobar involvement and/or shock (SPAS) was the primary outcome of interest. We constructed two multivariate logistic regression models to explain the likelihood of developing SPAS and to create a clinical prediction rule for developing SPAS that includes clinically relevant variables. Results: Laboratory-con firmed A(H1N1)pdm09, EQ-5D utility score 7 days before admission, more than one comorbidity, altered mental status, dyspnoea on arrival, days from onset of symptoms, and in fluenza season were associated with SPAS. In addition, not being vaccinated against seasonal influenza in the previous year, anaemia, altered mental status, fever and dyspnoea on arrival at hospital, difficulties in performing activities of daily living in the previous 7 days, and days from onset of symptoms to arrival at hospital were related to the likelihood of SPAS (area under the curve value of 0.75; Hosmer-Lemeshow p value of 0.84). Conclusions: These variables should be taken into account by physicians evaluating a patient affected by influenza as additional information to that provided by the usual risk scores.

Original languageEnglish (US)
Pages (from-to)301-307
Number of pages7
JournalEmergency Medicine Journal
Volume31
Issue number4
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Human Influenza
Shock
Pneumonia
Virus Diseases
Orthomyxoviridae
Dyspnea
Logistic Models
Preexisting Condition Coverage
Social Environment
Decision Support Techniques
Poisons
Pandemics
Activities of Daily Living
Infection
Habits
Area Under Curve
Comorbidity
Anemia
Vaccination
Cohort Studies

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Emergency Medicine
  • Medicine(all)

Cite this

Gutierrez, S. G., Quintana, J. M., Baricot, M., Bilbao, A., Capelastegui, A., Eguiluz, C. G. C., ... Morales, M. (2014). Predictive factors of severe multilobar pneumonia and shock in patients with influenza. Emergency Medicine Journal, 31(4), 301-307. https://doi.org/10.1136/emermed-2012-202081

Predictive factors of severe multilobar pneumonia and shock in patients with influenza. / Gutierrez, Susana Garcia; Quintana, José Maria; Baricot, Maretva; Bilbao, Amaia; Capelastegui, Alberto; Eguiluz, Carlos Gustavo Cilla; Domínguez, Angela; Castilla, Jesús; Godoy, Pere; Delgado-Rodríguez, Miguel; Soldevila, Nuŕia; Astray, Jenaro; Mayoral, José María; Martiń, Vicente; Gonzaĺez-Candelas, Fernando; Galań, Juan Carlos; Tamames, Sonia; Castro-Acosta, Ady Angeĺica; Gariń, Olatz; Pumarola, Tomaś; Bueno, M. A.; Gómez, M. L.; Mariscal, M.; Martínez, B.; Quesada, J. P.; Sillero, M.; Carnero, M.; Fernández-Crehuet, J.; Del Diego Salas, J.; Fuentes, V.; Gallardo, V.; Pérez, E.; López, R.; Maldonado, J. R.; Morillo, A.; Pedrosa Corral, I.; Bautista, M. F.; Navarro, J. M.; Pérez, M.; Oña, S.; Pérez, M. J.; Ubago, M. C.; Zarzuela, M.; Sanz, P.; Carriedo, D.; Díez, F.; Fernández, I.; Fernández, S.; Sanz, M. P.; Castrodeza, J. J.; Pérez, A.; De Ortiz Lejarazu, R.; Ortiz, J.; Pueyo, A.; Viejo, J. L.; Seco, A.; Redondo, P.; Molina, A.; Agustí, A.; Torres, A.; Trilla, A.; Vilella, A.; Barbé, F.; Blanch, L.; Navarro, G.; Bonfill, X.; López-Contreras, J.; Pomar, V.; Puig, M. T.; Borràs, E.; Martínez, A.; Torner, N.; Bravo, C.; Moraga, F.; Calafell, F.; Caylà, J.; Tortajada, C.; Garcia, I.; Ruiz, J.; García, J. J.; Alonso, J.; Gea, J.; Horcajada, J. P.; Hayes, N.; Rosell, A.; Dorca, J.; Saez, Marc; Álvarez, C.; Enríquez, M.; Pozo, F.; Baquero, F.; Cantón, R.; Robustillo, A.; Valdeón, M.; Córdoba, E.; Domínguez, F.; García, J.; Génova, R.; Gil, E.; Jiménez, S.; Lopaz, M. A.; López, J.; Martín, F.; Martínez, M. L.; Ordobás, M.; Rodriguez, E.; Sánchez, S.; Valdés, C.; Paño, J. R.; Romero, M.; Martínez, A.; Martínez, L.; Ruiz, M.; Fanlo, P.; Gil, F.; Martínez-Artola, V.; Quintana, J. M.; Aguirre, U.; España, P. P.; García, S.; Antoñana, J. M.; Astigarraga, I.; Pijoan, J. I.; Pocheville, I.; Santiago, M.; Villate, J. I.; Arístegui, J.; Escobar, A.; Garrote, M. I.; Bilbao, A.; Garaizar, C.; Korta, J.; Pérez-Trallero, E.; Sarasqueta, C.; Aizpuru, F.; Lobo, J. L.; Salado, C.; Alustiza, J.; Troya, F. J.; Blanquer, J.; Morales, M.

In: Emergency Medicine Journal, Vol. 31, No. 4, 2014, p. 301-307.

Research output: Contribution to journalArticle

Gutierrez, SG, Quintana, JM, Baricot, M, Bilbao, A, Capelastegui, A, Eguiluz, CGC, Domínguez, A, Castilla, J, Godoy, P, Delgado-Rodríguez, M, Soldevila, N, Astray, J, Mayoral, JM, Martiń, V, Gonzaĺez-Candelas, F, Galań, JC, Tamames, S, Castro-Acosta, AA, Gariń, O, Pumarola, T, Bueno, MA, Gómez, ML, Mariscal, M, Martínez, B, Quesada, JP, Sillero, M, Carnero, M, Fernández-Crehuet, J, Del Diego Salas, J, Fuentes, V, Gallardo, V, Pérez, E, López, R, Maldonado, JR, Morillo, A, Pedrosa Corral, I, Bautista, MF, Navarro, JM, Pérez, M, Oña, S, Pérez, MJ, Ubago, MC, Zarzuela, M, Sanz, P, Carriedo, D, Díez, F, Fernández, I, Fernández, S, Sanz, MP, Castrodeza, JJ, Pérez, A, De Ortiz Lejarazu, R, Ortiz, J, Pueyo, A, Viejo, JL, Seco, A, Redondo, P, Molina, A, Agustí, A, Torres, A, Trilla, A, Vilella, A, Barbé, F, Blanch, L, Navarro, G, Bonfill, X, López-Contreras, J, Pomar, V, Puig, MT, Borràs, E, Martínez, A, Torner, N, Bravo, C, Moraga, F, Calafell, F, Caylà, J, Tortajada, C, Garcia, I, Ruiz, J, García, JJ, Alonso, J, Gea, J, Horcajada, JP, Hayes, N, Rosell, A, Dorca, J, Saez, M, Álvarez, C, Enríquez, M, Pozo, F, Baquero, F, Cantón, R, Robustillo, A, Valdeón, M, Córdoba, E, Domínguez, F, García, J, Génova, R, Gil, E, Jiménez, S, Lopaz, MA, López, J, Martín, F, Martínez, ML, Ordobás, M, Rodriguez, E, Sánchez, S, Valdés, C, Paño, JR, Romero, M, Martínez, A, Martínez, L, Ruiz, M, Fanlo, P, Gil, F, Martínez-Artola, V, Quintana, JM, Aguirre, U, España, PP, García, S, Antoñana, JM, Astigarraga, I, Pijoan, JI, Pocheville, I, Santiago, M, Villate, JI, Arístegui, J, Escobar, A, Garrote, MI, Bilbao, A, Garaizar, C, Korta, J, Pérez-Trallero, E, Sarasqueta, C, Aizpuru, F, Lobo, JL, Salado, C, Alustiza, J, Troya, FJ, Blanquer, J & Morales, M 2014, 'Predictive factors of severe multilobar pneumonia and shock in patients with influenza', Emergency Medicine Journal, vol. 31, no. 4, pp. 301-307. https://doi.org/10.1136/emermed-2012-202081
Gutierrez SG, Quintana JM, Baricot M, Bilbao A, Capelastegui A, Eguiluz CGC et al. Predictive factors of severe multilobar pneumonia and shock in patients with influenza. Emergency Medicine Journal. 2014;31(4):301-307. https://doi.org/10.1136/emermed-2012-202081
Gutierrez, Susana Garcia ; Quintana, José Maria ; Baricot, Maretva ; Bilbao, Amaia ; Capelastegui, Alberto ; Eguiluz, Carlos Gustavo Cilla ; Domínguez, Angela ; Castilla, Jesús ; Godoy, Pere ; Delgado-Rodríguez, Miguel ; Soldevila, Nuŕia ; Astray, Jenaro ; Mayoral, José María ; Martiń, Vicente ; Gonzaĺez-Candelas, Fernando ; Galań, Juan Carlos ; Tamames, Sonia ; Castro-Acosta, Ady Angeĺica ; Gariń, Olatz ; Pumarola, Tomaś ; Bueno, M. A. ; Gómez, M. L. ; Mariscal, M. ; Martínez, B. ; Quesada, J. P. ; Sillero, M. ; Carnero, M. ; Fernández-Crehuet, J. ; Del Diego Salas, J. ; Fuentes, V. ; Gallardo, V. ; Pérez, E. ; López, R. ; Maldonado, J. R. ; Morillo, A. ; Pedrosa Corral, I. ; Bautista, M. F. ; Navarro, J. M. ; Pérez, M. ; Oña, S. ; Pérez, M. J. ; Ubago, M. C. ; Zarzuela, M. ; Sanz, P. ; Carriedo, D. ; Díez, F. ; Fernández, I. ; Fernández, S. ; Sanz, M. P. ; Castrodeza, J. J. ; Pérez, A. ; De Ortiz Lejarazu, R. ; Ortiz, J. ; Pueyo, A. ; Viejo, J. L. ; Seco, A. ; Redondo, P. ; Molina, A. ; Agustí, A. ; Torres, A. ; Trilla, A. ; Vilella, A. ; Barbé, F. ; Blanch, L. ; Navarro, G. ; Bonfill, X. ; López-Contreras, J. ; Pomar, V. ; Puig, M. T. ; Borràs, E. ; Martínez, A. ; Torner, N. ; Bravo, C. ; Moraga, F. ; Calafell, F. ; Caylà, J. ; Tortajada, C. ; Garcia, I. ; Ruiz, J. ; García, J. J. ; Alonso, J. ; Gea, J. ; Horcajada, J. P. ; Hayes, N. ; Rosell, A. ; Dorca, J. ; Saez, Marc ; Álvarez, C. ; Enríquez, M. ; Pozo, F. ; Baquero, F. ; Cantón, R. ; Robustillo, A. ; Valdeón, M. ; Córdoba, E. ; Domínguez, F. ; García, J. ; Génova, R. ; Gil, E. ; Jiménez, S. ; Lopaz, M. A. ; López, J. ; Martín, F. ; Martínez, M. L. ; Ordobás, M. ; Rodriguez, E. ; Sánchez, S. ; Valdés, C. ; Paño, J. R. ; Romero, M. ; Martínez, A. ; Martínez, L. ; Ruiz, M. ; Fanlo, P. ; Gil, F. ; Martínez-Artola, V. ; Quintana, J. M. ; Aguirre, U. ; España, P. P. ; García, S. ; Antoñana, J. M. ; Astigarraga, I. ; Pijoan, J. I. ; Pocheville, I. ; Santiago, M. ; Villate, J. I. ; Arístegui, J. ; Escobar, A. ; Garrote, M. I. ; Bilbao, A. ; Garaizar, C. ; Korta, J. ; Pérez-Trallero, E. ; Sarasqueta, C. ; Aizpuru, F. ; Lobo, J. L. ; Salado, C. ; Alustiza, J. ; Troya, F. J. ; Blanquer, J. ; Morales, M. / Predictive factors of severe multilobar pneumonia and shock in patients with influenza. In: Emergency Medicine Journal. 2014 ; Vol. 31, No. 4. pp. 301-307.
@article{727fad6a837648a1b273790fe5ccbcf7,
title = "Predictive factors of severe multilobar pneumonia and shock in patients with influenza",
abstract = "Purpose: To identify risk factors present at admission in adult patients hospitalised due to influenza virus infection during the 2009/10 and 2010/11 seasons - including whether infection was from pandemic or seasonal influenza A infections - that were associated with the likelihood of developing severe pneumonia with multilobar involvement and shock. Methods: Prospective cohort study. Patients hospitalised due to influenza virus infection were recruited. We collected information on sociodemographic characteristics, pre-existing medical conditions, vaccinations, toxic habits, previous medications, exposure to social environments, and EuroQoL-5D (EQ-5D). Severe pneumonia with multilobar involvement and/or shock (SPAS) was the primary outcome of interest. We constructed two multivariate logistic regression models to explain the likelihood of developing SPAS and to create a clinical prediction rule for developing SPAS that includes clinically relevant variables. Results: Laboratory-con firmed A(H1N1)pdm09, EQ-5D utility score 7 days before admission, more than one comorbidity, altered mental status, dyspnoea on arrival, days from onset of symptoms, and in fluenza season were associated with SPAS. In addition, not being vaccinated against seasonal influenza in the previous year, anaemia, altered mental status, fever and dyspnoea on arrival at hospital, difficulties in performing activities of daily living in the previous 7 days, and days from onset of symptoms to arrival at hospital were related to the likelihood of SPAS (area under the curve value of 0.75; Hosmer-Lemeshow p value of 0.84). Conclusions: These variables should be taken into account by physicians evaluating a patient affected by influenza as additional information to that provided by the usual risk scores.",
author = "Gutierrez, {Susana Garcia} and Quintana, {Jos{\'e} Maria} and Maretva Baricot and Amaia Bilbao and Alberto Capelastegui and Eguiluz, {Carlos Gustavo Cilla} and Angela Dom{\'i}nguez and Jes{\'u}s Castilla and Pere Godoy and Miguel Delgado-Rodr{\'i}guez and Nuŕia Soldevila and Jenaro Astray and Mayoral, {Jos{\'e} Mar{\'i}a} and Vicente Martiń and Fernando Gonzaĺez-Candelas and Galań, {Juan Carlos} and Sonia Tamames and Castro-Acosta, {Ady Angeĺica} and Olatz Gariń and Tomaś Pumarola and Bueno, {M. A.} and G{\'o}mez, {M. L.} and M. Mariscal and B. Mart{\'i}nez and Quesada, {J. P.} and M. Sillero and M. Carnero and J. Fern{\'a}ndez-Crehuet and {Del Diego Salas}, J. and V. Fuentes and V. Gallardo and E. P{\'e}rez and R. L{\'o}pez and Maldonado, {J. R.} and A. Morillo and {Pedrosa Corral}, I. and Bautista, {M. F.} and Navarro, {J. M.} and M. P{\'e}rez and S. O{\~n}a and P{\'e}rez, {M. J.} and Ubago, {M. C.} and M. Zarzuela and P. Sanz and D. Carriedo and F. D{\'i}ez and I. Fern{\'a}ndez and S. Fern{\'a}ndez and Sanz, {M. P.} and Castrodeza, {J. J.} and A. P{\'e}rez and {De Ortiz Lejarazu}, R. and J. Ortiz and A. Pueyo and Viejo, {J. L.} and A. Seco and P. Redondo and A. Molina and A. Agust{\'i} and A. Torres and A. Trilla and A. Vilella and F. Barb{\'e} and L. Blanch and G. Navarro and X. Bonfill and J. L{\'o}pez-Contreras and V. Pomar and Puig, {M. T.} and E. Borr{\`a}s and A. Mart{\'i}nez and N. Torner and C. Bravo and F. Moraga and F. Calafell and J. Cayl{\`a} and C. Tortajada and I. Garcia and J. Ruiz and Garc{\'i}a, {J. J.} and J. Alonso and J. Gea and Horcajada, {J. P.} and N. Hayes and A. Rosell and J. Dorca and Marc Saez and C. {\'A}lvarez and M. Enr{\'i}quez and F. Pozo and F. Baquero and R. Cant{\'o}n and A. Robustillo and M. Valde{\'o}n and E. C{\'o}rdoba and F. Dom{\'i}nguez and J. Garc{\'i}a and R. G{\'e}nova and E. Gil and S. Jim{\'e}nez and Lopaz, {M. A.} and J. L{\'o}pez and F. Mart{\'i}n and Mart{\'i}nez, {M. L.} and M. Ordob{\'a}s and E. Rodriguez and S. S{\'a}nchez and C. Vald{\'e}s and Pa{\~n}o, {J. R.} and M. Romero and A. Mart{\'i}nez and L. Mart{\'i}nez and M. Ruiz and P. Fanlo and F. Gil and V. Mart{\'i}nez-Artola and Quintana, {J. M.} and U. Aguirre and Espa{\~n}a, {P. P.} and S. Garc{\'i}a and Anto{\~n}ana, {J. M.} and I. Astigarraga and Pijoan, {J. I.} and I. Pocheville and M. Santiago and Villate, {J. I.} and J. Ar{\'i}stegui and A. Escobar and Garrote, {M. I.} and A. Bilbao and C. Garaizar and J. Korta and E. P{\'e}rez-Trallero and C. Sarasqueta and F. Aizpuru and Lobo, {J. L.} and C. Salado and J. Alustiza and Troya, {F. J.} and J. Blanquer and M. Morales",
year = "2014",
doi = "10.1136/emermed-2012-202081",
language = "English (US)",
volume = "31",
pages = "301--307",
journal = "Emergency Medicine Journal",
issn = "1472-0205",
publisher = "BMJ Publishing Group",
number = "4",

}

TY - JOUR

T1 - Predictive factors of severe multilobar pneumonia and shock in patients with influenza

AU - Gutierrez, Susana Garcia

AU - Quintana, José Maria

AU - Baricot, Maretva

AU - Bilbao, Amaia

AU - Capelastegui, Alberto

AU - Eguiluz, Carlos Gustavo Cilla

AU - Domínguez, Angela

AU - Castilla, Jesús

AU - Godoy, Pere

AU - Delgado-Rodríguez, Miguel

AU - Soldevila, Nuŕia

AU - Astray, Jenaro

AU - Mayoral, José María

AU - Martiń, Vicente

AU - Gonzaĺez-Candelas, Fernando

AU - Galań, Juan Carlos

AU - Tamames, Sonia

AU - Castro-Acosta, Ady Angeĺica

AU - Gariń, Olatz

AU - Pumarola, Tomaś

AU - Bueno, M. A.

AU - Gómez, M. L.

AU - Mariscal, M.

AU - Martínez, B.

AU - Quesada, J. P.

AU - Sillero, M.

AU - Carnero, M.

AU - Fernández-Crehuet, J.

AU - Del Diego Salas, J.

AU - Fuentes, V.

AU - Gallardo, V.

AU - Pérez, E.

AU - López, R.

AU - Maldonado, J. R.

AU - Morillo, A.

AU - Pedrosa Corral, I.

AU - Bautista, M. F.

AU - Navarro, J. M.

AU - Pérez, M.

AU - Oña, S.

AU - Pérez, M. J.

AU - Ubago, M. C.

AU - Zarzuela, M.

AU - Sanz, P.

AU - Carriedo, D.

AU - Díez, F.

AU - Fernández, I.

AU - Fernández, S.

AU - Sanz, M. P.

AU - Castrodeza, J. J.

AU - Pérez, A.

AU - De Ortiz Lejarazu, R.

AU - Ortiz, J.

AU - Pueyo, A.

AU - Viejo, J. L.

AU - Seco, A.

AU - Redondo, P.

AU - Molina, A.

AU - Agustí, A.

AU - Torres, A.

AU - Trilla, A.

AU - Vilella, A.

AU - Barbé, F.

AU - Blanch, L.

AU - Navarro, G.

AU - Bonfill, X.

AU - López-Contreras, J.

AU - Pomar, V.

AU - Puig, M. T.

AU - Borràs, E.

AU - Martínez, A.

AU - Torner, N.

AU - Bravo, C.

AU - Moraga, F.

AU - Calafell, F.

AU - Caylà, J.

AU - Tortajada, C.

AU - Garcia, I.

AU - Ruiz, J.

AU - García, J. J.

AU - Alonso, J.

AU - Gea, J.

AU - Horcajada, J. P.

AU - Hayes, N.

AU - Rosell, A.

AU - Dorca, J.

AU - Saez, Marc

AU - Álvarez, C.

AU - Enríquez, M.

AU - Pozo, F.

AU - Baquero, F.

AU - Cantón, R.

AU - Robustillo, A.

AU - Valdeón, M.

AU - Córdoba, E.

AU - Domínguez, F.

AU - García, J.

AU - Génova, R.

AU - Gil, E.

AU - Jiménez, S.

AU - Lopaz, M. A.

AU - López, J.

AU - Martín, F.

AU - Martínez, M. L.

AU - Ordobás, M.

AU - Rodriguez, E.

AU - Sánchez, S.

AU - Valdés, C.

AU - Paño, J. R.

AU - Romero, M.

AU - Martínez, A.

AU - Martínez, L.

AU - Ruiz, M.

AU - Fanlo, P.

AU - Gil, F.

AU - Martínez-Artola, V.

AU - Quintana, J. M.

AU - Aguirre, U.

AU - España, P. P.

AU - García, S.

AU - Antoñana, J. M.

AU - Astigarraga, I.

AU - Pijoan, J. I.

AU - Pocheville, I.

AU - Santiago, M.

AU - Villate, J. I.

AU - Arístegui, J.

AU - Escobar, A.

AU - Garrote, M. I.

AU - Bilbao, A.

AU - Garaizar, C.

AU - Korta, J.

AU - Pérez-Trallero, E.

AU - Sarasqueta, C.

AU - Aizpuru, F.

AU - Lobo, J. L.

AU - Salado, C.

AU - Alustiza, J.

AU - Troya, F. J.

AU - Blanquer, J.

AU - Morales, M.

PY - 2014

Y1 - 2014

N2 - Purpose: To identify risk factors present at admission in adult patients hospitalised due to influenza virus infection during the 2009/10 and 2010/11 seasons - including whether infection was from pandemic or seasonal influenza A infections - that were associated with the likelihood of developing severe pneumonia with multilobar involvement and shock. Methods: Prospective cohort study. Patients hospitalised due to influenza virus infection were recruited. We collected information on sociodemographic characteristics, pre-existing medical conditions, vaccinations, toxic habits, previous medications, exposure to social environments, and EuroQoL-5D (EQ-5D). Severe pneumonia with multilobar involvement and/or shock (SPAS) was the primary outcome of interest. We constructed two multivariate logistic regression models to explain the likelihood of developing SPAS and to create a clinical prediction rule for developing SPAS that includes clinically relevant variables. Results: Laboratory-con firmed A(H1N1)pdm09, EQ-5D utility score 7 days before admission, more than one comorbidity, altered mental status, dyspnoea on arrival, days from onset of symptoms, and in fluenza season were associated with SPAS. In addition, not being vaccinated against seasonal influenza in the previous year, anaemia, altered mental status, fever and dyspnoea on arrival at hospital, difficulties in performing activities of daily living in the previous 7 days, and days from onset of symptoms to arrival at hospital were related to the likelihood of SPAS (area under the curve value of 0.75; Hosmer-Lemeshow p value of 0.84). Conclusions: These variables should be taken into account by physicians evaluating a patient affected by influenza as additional information to that provided by the usual risk scores.

AB - Purpose: To identify risk factors present at admission in adult patients hospitalised due to influenza virus infection during the 2009/10 and 2010/11 seasons - including whether infection was from pandemic or seasonal influenza A infections - that were associated with the likelihood of developing severe pneumonia with multilobar involvement and shock. Methods: Prospective cohort study. Patients hospitalised due to influenza virus infection were recruited. We collected information on sociodemographic characteristics, pre-existing medical conditions, vaccinations, toxic habits, previous medications, exposure to social environments, and EuroQoL-5D (EQ-5D). Severe pneumonia with multilobar involvement and/or shock (SPAS) was the primary outcome of interest. We constructed two multivariate logistic regression models to explain the likelihood of developing SPAS and to create a clinical prediction rule for developing SPAS that includes clinically relevant variables. Results: Laboratory-con firmed A(H1N1)pdm09, EQ-5D utility score 7 days before admission, more than one comorbidity, altered mental status, dyspnoea on arrival, days from onset of symptoms, and in fluenza season were associated with SPAS. In addition, not being vaccinated against seasonal influenza in the previous year, anaemia, altered mental status, fever and dyspnoea on arrival at hospital, difficulties in performing activities of daily living in the previous 7 days, and days from onset of symptoms to arrival at hospital were related to the likelihood of SPAS (area under the curve value of 0.75; Hosmer-Lemeshow p value of 0.84). Conclusions: These variables should be taken into account by physicians evaluating a patient affected by influenza as additional information to that provided by the usual risk scores.

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U2 - 10.1136/emermed-2012-202081

DO - 10.1136/emermed-2012-202081

M3 - Article

VL - 31

SP - 301

EP - 307

JO - Emergency Medicine Journal

JF - Emergency Medicine Journal

SN - 1472-0205

IS - 4

ER -