Epidemiology of invasive aspergillosis in critically ill patients: clinical presentation, underlying conditions, and outcomes.
Identifieur interne : 003100 ( PubMed/Corpus ); précédent : 003099; suivant : 003101Epidemiology of invasive aspergillosis in critically ill patients: clinical presentation, underlying conditions, and outcomes.
Auteurs : Fabio Silvio Taccone ; Anne-Marie Van Den Abeele ; Pierre Bulpa ; Benoit Misset ; Wouter Meersseman ; Teresa Cardoso ; José-Artur Paiva ; Miguel Blasco-Navalpotro ; Emmanuel De Laere ; George Dimopoulos ; Jordi Rello ; Dirk Vogelaers ; Stijn I. BlotSource :
- Critical care (London, England) [ 1466-609X ] ; 2015.
English descriptors
- KwdEn :
- Adult, Aged, Comorbidity, Critical Illness, Female, Humans, Immunocompromised Host, Incidence, Intensive Care Units, Male, Middle Aged, Opportunistic Infections (diagnosis), Opportunistic Infections (mortality), Pulmonary Aspergillosis (complications), Pulmonary Aspergillosis (diagnosis), Pulmonary Aspergillosis (mortality), Respiration, Artificial (adverse effects), Risk Factors.
- MESH :
- adverse effects : Respiration, Artificial.
- complications : Pulmonary Aspergillosis.
- diagnosis : Opportunistic Infections, Pulmonary Aspergillosis.
- mortality : Opportunistic Infections, Pulmonary Aspergillosis.
- Adult, Aged, Comorbidity, Critical Illness, Female, Humans, Immunocompromised Host, Incidence, Intensive Care Units, Male, Middle Aged, Risk Factors.
Abstract
Invasive aspergillosis (IA) is a fungal infection that particularly affects immunocompromised hosts. Recently, several studies have indicated a high incidence of IA in intensive care unit (ICU) patients. However, few data are available on the epidemiology and outcome of patients with IA in this setting.
DOI: 10.1186/s13054-014-0722-7
PubMed: 25928694
Links to Exploration step
pubmed:25928694Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Epidemiology of invasive aspergillosis in critically ill patients: clinical presentation, underlying conditions, and outcomes.</title><author><name sortKey="Taccone, Fabio Silvio" sort="Taccone, Fabio Silvio" uniqKey="Taccone F" first="Fabio Silvio" last="Taccone">Fabio Silvio Taccone</name><affiliation><nlm:affiliation>Department of Intensive Care Erasme Hospital, Free University of Brussels, Route de Lennik 808, 1070, Brussels, Belgium. ftaccone@ulb.ac.be.</nlm:affiliation></affiliation></author><author><name sortKey="Van Den Abeele, Anne Marie" sort="Van Den Abeele, Anne Marie" uniqKey="Van Den Abeele A" first="Anne-Marie" last="Van Den Abeele">Anne-Marie Van Den Abeele</name><affiliation><nlm:affiliation>Department of Microbiology General Hospital St. Lucas, Groenebriel 1, 9000, Ghent, Belgium. anne-marie.vandenabeele@azstlucas.be.</nlm:affiliation></affiliation></author><author><name sortKey="Bulpa, Pierre" sort="Bulpa, Pierre" uniqKey="Bulpa P" first="Pierre" last="Bulpa">Pierre Bulpa</name><affiliation><nlm:affiliation>Department of Intensive Care Mont-Godinne University Hospital, Catholic University of Louvain, Avenue G.Thérasse 1, 5530, Yvoir, Belgium. pierre.bulpa@aclouvain.be.</nlm:affiliation></affiliation></author><author><name sortKey="Misset, Benoit" sort="Misset, Benoit" uniqKey="Misset B" first="Benoit" last="Misset">Benoit Misset</name><affiliation><nlm:affiliation>Department of Intensive Care Foundation Hospital Saint-Joseph, Paris-Descartes University, 185 Rue Raymond Losserand, 75014, Paris, France. bmisset@hpsj.fr.</nlm:affiliation></affiliation></author><author><name sortKey="Meersseman, Wouter" sort="Meersseman, Wouter" uniqKey="Meersseman W" first="Wouter" last="Meersseman">Wouter Meersseman</name><affiliation><nlm:affiliation>Medical Intensive Care Unit, University Hospital Leuven, Herestraat 49, 3000, Leuven, Belgium. wouter.meersseman@uzleuven.be.</nlm:affiliation></affiliation></author><author><name sortKey="Cardoso, Teresa" sort="Cardoso, Teresa" uniqKey="Cardoso T" first="Teresa" last="Cardoso">Teresa Cardoso</name><affiliation><nlm:affiliation>Department of Intensive Care, Santo Antonio Hospital, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal. cardoso.tmc@gmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Paiva, Jose Artur" sort="Paiva, Jose Artur" uniqKey="Paiva J" first="José-Artur" last="Paiva">José-Artur Paiva</name><affiliation><nlm:affiliation>Department of Emergency and Intensive Care, Hospital Centre S. Joao and University of Porto Medical School Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal. jarturpaiva@gmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Blasco Navalpotro, Miguel" sort="Blasco Navalpotro, Miguel" uniqKey="Blasco Navalpotro M" first="Miguel" last="Blasco-Navalpotro">Miguel Blasco-Navalpotro</name><affiliation><nlm:affiliation>Department of Intensive Care, University Hospital Severo Ochoa, Avenida de Orellana, s/n 28911, Leganés, Madrid, Spain. mblasco.hsvo@salud.madrid.org.</nlm:affiliation></affiliation></author><author><name sortKey="De Laere, Emmanuel" sort="De Laere, Emmanuel" uniqKey="De Laere E" first="Emmanuel" last="De Laere">Emmanuel De Laere</name><affiliation><nlm:affiliation>Department of Microbiology, General Hospital Delta, Brugsesteenweg 90, 8800, Roeselare, Belgium. emmanuel.delaere@azdelta.be.</nlm:affiliation></affiliation></author><author><name sortKey="Dimopoulos, George" sort="Dimopoulos, George" uniqKey="Dimopoulos G" first="George" last="Dimopoulos">George Dimopoulos</name><affiliation><nlm:affiliation>Department of Critical Care Medicine, Attikon University Hospital, University of Athens Medical School, 1 Rimini Street, Haidari, 124 62, Athens, Greece. gdimop@med.uoa.gr.</nlm:affiliation></affiliation></author><author><name sortKey="Rello, Jordi" sort="Rello, Jordi" uniqKey="Rello J" first="Jordi" last="Rello">Jordi Rello</name><affiliation><nlm:affiliation>Hospital Universitari Vall d'Hebron, Vall D'Hebron, Institute of Research, CIBERES, Autonomous University of Barcelona, Passeig Vall d'Hebron, 119-129, 08035, Barcelona, Spain. jrello@crips.es.</nlm:affiliation></affiliation></author><author><name sortKey="Vogelaers, Dirk" sort="Vogelaers, Dirk" uniqKey="Vogelaers D" first="Dirk" last="Vogelaers">Dirk Vogelaers</name><affiliation><nlm:affiliation>Department of Internal Medicine Faculty of Medicine & Health Science, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium. dirk.vogelaers@uzgent.be.</nlm:affiliation></affiliation></author><author><name sortKey="Blot, Stijn I" sort="Blot, Stijn I" uniqKey="Blot S" first="Stijn I" last="Blot">Stijn I. Blot</name><affiliation><nlm:affiliation>Department of Internal Medicine Faculty of Medicine & Health Science, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium. stijn.blot@ugent.be.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2015">2015</date><idno type="RBID">pubmed:25928694</idno><idno type="pmid">25928694</idno><idno type="doi">10.1186/s13054-014-0722-7</idno><idno type="wicri:Area/PubMed/Corpus">003100</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">003100</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Epidemiology of invasive aspergillosis in critically ill patients: clinical presentation, underlying conditions, and outcomes.</title><author><name sortKey="Taccone, Fabio Silvio" sort="Taccone, Fabio Silvio" uniqKey="Taccone F" first="Fabio Silvio" last="Taccone">Fabio Silvio Taccone</name><affiliation><nlm:affiliation>Department of Intensive Care Erasme Hospital, Free University of Brussels, Route de Lennik 808, 1070, Brussels, Belgium. ftaccone@ulb.ac.be.</nlm:affiliation></affiliation></author><author><name sortKey="Van Den Abeele, Anne Marie" sort="Van Den Abeele, Anne Marie" uniqKey="Van Den Abeele A" first="Anne-Marie" last="Van Den Abeele">Anne-Marie Van Den Abeele</name><affiliation><nlm:affiliation>Department of Microbiology General Hospital St. Lucas, Groenebriel 1, 9000, Ghent, Belgium. anne-marie.vandenabeele@azstlucas.be.</nlm:affiliation></affiliation></author><author><name sortKey="Bulpa, Pierre" sort="Bulpa, Pierre" uniqKey="Bulpa P" first="Pierre" last="Bulpa">Pierre Bulpa</name><affiliation><nlm:affiliation>Department of Intensive Care Mont-Godinne University Hospital, Catholic University of Louvain, Avenue G.Thérasse 1, 5530, Yvoir, Belgium. pierre.bulpa@aclouvain.be.</nlm:affiliation></affiliation></author><author><name sortKey="Misset, Benoit" sort="Misset, Benoit" uniqKey="Misset B" first="Benoit" last="Misset">Benoit Misset</name><affiliation><nlm:affiliation>Department of Intensive Care Foundation Hospital Saint-Joseph, Paris-Descartes University, 185 Rue Raymond Losserand, 75014, Paris, France. bmisset@hpsj.fr.</nlm:affiliation></affiliation></author><author><name sortKey="Meersseman, Wouter" sort="Meersseman, Wouter" uniqKey="Meersseman W" first="Wouter" last="Meersseman">Wouter Meersseman</name><affiliation><nlm:affiliation>Medical Intensive Care Unit, University Hospital Leuven, Herestraat 49, 3000, Leuven, Belgium. wouter.meersseman@uzleuven.be.</nlm:affiliation></affiliation></author><author><name sortKey="Cardoso, Teresa" sort="Cardoso, Teresa" uniqKey="Cardoso T" first="Teresa" last="Cardoso">Teresa Cardoso</name><affiliation><nlm:affiliation>Department of Intensive Care, Santo Antonio Hospital, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal. cardoso.tmc@gmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Paiva, Jose Artur" sort="Paiva, Jose Artur" uniqKey="Paiva J" first="José-Artur" last="Paiva">José-Artur Paiva</name><affiliation><nlm:affiliation>Department of Emergency and Intensive Care, Hospital Centre S. Joao and University of Porto Medical School Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal. jarturpaiva@gmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Blasco Navalpotro, Miguel" sort="Blasco Navalpotro, Miguel" uniqKey="Blasco Navalpotro M" first="Miguel" last="Blasco-Navalpotro">Miguel Blasco-Navalpotro</name><affiliation><nlm:affiliation>Department of Intensive Care, University Hospital Severo Ochoa, Avenida de Orellana, s/n 28911, Leganés, Madrid, Spain. mblasco.hsvo@salud.madrid.org.</nlm:affiliation></affiliation></author><author><name sortKey="De Laere, Emmanuel" sort="De Laere, Emmanuel" uniqKey="De Laere E" first="Emmanuel" last="De Laere">Emmanuel De Laere</name><affiliation><nlm:affiliation>Department of Microbiology, General Hospital Delta, Brugsesteenweg 90, 8800, Roeselare, Belgium. emmanuel.delaere@azdelta.be.</nlm:affiliation></affiliation></author><author><name sortKey="Dimopoulos, George" sort="Dimopoulos, George" uniqKey="Dimopoulos G" first="George" last="Dimopoulos">George Dimopoulos</name><affiliation><nlm:affiliation>Department of Critical Care Medicine, Attikon University Hospital, University of Athens Medical School, 1 Rimini Street, Haidari, 124 62, Athens, Greece. gdimop@med.uoa.gr.</nlm:affiliation></affiliation></author><author><name sortKey="Rello, Jordi" sort="Rello, Jordi" uniqKey="Rello J" first="Jordi" last="Rello">Jordi Rello</name><affiliation><nlm:affiliation>Hospital Universitari Vall d'Hebron, Vall D'Hebron, Institute of Research, CIBERES, Autonomous University of Barcelona, Passeig Vall d'Hebron, 119-129, 08035, Barcelona, Spain. jrello@crips.es.</nlm:affiliation></affiliation></author><author><name sortKey="Vogelaers, Dirk" sort="Vogelaers, Dirk" uniqKey="Vogelaers D" first="Dirk" last="Vogelaers">Dirk Vogelaers</name><affiliation><nlm:affiliation>Department of Internal Medicine Faculty of Medicine & Health Science, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium. dirk.vogelaers@uzgent.be.</nlm:affiliation></affiliation></author><author><name sortKey="Blot, Stijn I" sort="Blot, Stijn I" uniqKey="Blot S" first="Stijn I" last="Blot">Stijn I. Blot</name><affiliation><nlm:affiliation>Department of Internal Medicine Faculty of Medicine & Health Science, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium. stijn.blot@ugent.be.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Critical care (London, England)</title><idno type="eISSN">1466-609X</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Comorbidity</term><term>Critical Illness</term><term>Female</term><term>Humans</term><term>Immunocompromised Host</term><term>Incidence</term><term>Intensive Care Units</term><term>Male</term><term>Middle Aged</term><term>Opportunistic Infections (diagnosis)</term><term>Opportunistic Infections (mortality)</term><term>Pulmonary Aspergillosis (complications)</term><term>Pulmonary Aspergillosis (diagnosis)</term><term>Pulmonary Aspergillosis (mortality)</term><term>Respiration, Artificial (adverse effects)</term><term>Risk Factors</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Respiration, Artificial</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Pulmonary Aspergillosis</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Opportunistic Infections</term><term>Pulmonary Aspergillosis</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Opportunistic Infections</term><term>Pulmonary Aspergillosis</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Comorbidity</term><term>Critical Illness</term><term>Female</term><term>Humans</term><term>Immunocompromised Host</term><term>Incidence</term><term>Intensive Care Units</term><term>Male</term><term>Middle Aged</term><term>Risk Factors</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Invasive aspergillosis (IA) is a fungal infection that particularly affects immunocompromised hosts. Recently, several studies have indicated a high incidence of IA in intensive care unit (ICU) patients. However, few data are available on the epidemiology and outcome of patients with IA in this setting.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">25928694</PMID><DateCreated><Year>2015</Year><Month>05</Month><Day>01</Day></DateCreated><DateCompleted><Year>2016</Year><Month>01</Month><Day>01</Day></DateCompleted><DateRevised><Year>2015</Year><Month>05</Month><Day>05</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1466-609X</ISSN><JournalIssue CitedMedium="Internet"><Volume>19</Volume><PubDate><Year>2015</Year><Month>Jan</Month><Day>12</Day></PubDate></JournalIssue><Title>Critical care (London, England)</Title><ISOAbbreviation>Crit Care</ISOAbbreviation></Journal><ArticleTitle>Epidemiology of invasive aspergillosis in critically ill patients: clinical presentation, underlying conditions, and outcomes.</ArticleTitle><Pagination><MedlinePgn>7</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s13054-014-0722-7</ELocationID><Abstract><AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">Invasive aspergillosis (IA) is a fungal infection that particularly affects immunocompromised hosts. Recently, several studies have indicated a high incidence of IA in intensive care unit (ICU) patients. However, few data are available on the epidemiology and outcome of patients with IA in this setting.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">An observational study including all patients with a positive Aspergillus culture during ICU stay was performed in 30 ICUs in 8 countries. Cases were classified as proven IA, putative IA or Aspergillus colonization according to recently validated criteria. Demographic, microbiologic and diagnostic data were collected. Outcome was recorded 12 weeks after Aspergillus isolation.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">A total of 563 patients were included, of whom 266 were colonized (47%), 203 had putative IA (36%) and 94 had proven IA (17%). The lung was the most frequent site of infection (94%), and Aspergillus fumigatus the most commonly isolated species (92%). Patients with IA had higher incidences of cancer and organ transplantation than those with colonization. Compared with other patients, they were more frequently diagnosed with sepsis on ICU admission and more frequently received vasopressors and renal replacement therapy (RRT) during the ICU stay. Mortality was 38% among colonized patients, 67% in those with putative IA and 79% in those with proven IA (P < 0.001). Independent risk factors for death among patients with IA included older age, history of bone marrow transplantation, and mechanical ventilation, RRT and higher Sequential Organ Failure Assessment score at diagnosis.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">IA among critically ill patients is associated with high mortality. Patients diagnosed with proven or putative IA had greater severity of illness and more frequently needed organ support than those with Aspergillus spp colonization.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Taccone</LastName><ForeName>Fabio Silvio</ForeName><Initials>FS</Initials><AffiliationInfo><Affiliation>Department of Intensive Care Erasme Hospital, Free University of Brussels, Route de Lennik 808, 1070, Brussels, Belgium. ftaccone@ulb.ac.be.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Van den Abeele</LastName><ForeName>Anne-Marie</ForeName><Initials>AM</Initials><AffiliationInfo><Affiliation>Department of Microbiology General Hospital St. Lucas, Groenebriel 1, 9000, Ghent, Belgium. anne-marie.vandenabeele@azstlucas.be.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bulpa</LastName><ForeName>Pierre</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Intensive Care Mont-Godinne University Hospital, Catholic University of Louvain, Avenue G.Thérasse 1, 5530, Yvoir, Belgium. pierre.bulpa@aclouvain.be.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Misset</LastName><ForeName>Benoit</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Intensive Care Foundation Hospital Saint-Joseph, Paris-Descartes University, 185 Rue Raymond Losserand, 75014, Paris, France. bmisset@hpsj.fr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Meersseman</LastName><ForeName>Wouter</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Medical Intensive Care Unit, University Hospital Leuven, Herestraat 49, 3000, Leuven, Belgium. wouter.meersseman@uzleuven.be.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cardoso</LastName><ForeName>Teresa</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Intensive Care, Santo Antonio Hospital, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal. cardoso.tmc@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Paiva</LastName><ForeName>José-Artur</ForeName><Initials>JA</Initials><AffiliationInfo><Affiliation>Department of Emergency and Intensive Care, Hospital Centre S. Joao and University of Porto Medical School Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal. jarturpaiva@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Blasco-Navalpotro</LastName><ForeName>Miguel</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Intensive Care, University Hospital Severo Ochoa, Avenida de Orellana, s/n 28911, Leganés, Madrid, Spain. mblasco.hsvo@salud.madrid.org.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>De Laere</LastName><ForeName>Emmanuel</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Microbiology, General Hospital Delta, Brugsesteenweg 90, 8800, Roeselare, Belgium. emmanuel.delaere@azdelta.be.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dimopoulos</LastName><ForeName>George</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Critical Care Medicine, Attikon University Hospital, University of Athens Medical School, 1 Rimini Street, Haidari, 124 62, Athens, Greece. gdimop@med.uoa.gr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rello</LastName><ForeName>Jordi</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Hospital Universitari Vall d'Hebron, Vall D'Hebron, Institute of Research, CIBERES, Autonomous University of Barcelona, Passeig Vall d'Hebron, 119-129, 08035, Barcelona, Spain. jrello@crips.es.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vogelaers</LastName><ForeName>Dirk</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Internal Medicine Faculty of Medicine & Health Science, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium. dirk.vogelaers@uzgent.be.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Blot</LastName><ForeName>Stijn I</ForeName><Initials>SI</Initials><AffiliationInfo><Affiliation>Department of Internal Medicine Faculty of Medicine & Health Science, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium. stijn.blot@ugent.be.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Burns, Trauma, and Critical Care Research Centre, The University of Queensland, Butterfield Street, Herston (Brisbane), 4006, Queensland, Australia. stijn.blot@ugent.be.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>AspICU Study Investigators</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D064888">Observational Study</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>01</Month><Day>12</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Crit 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