Predictive factors of severe multilobar pneumonia and shock in patients with influenza.
Identifieur interne : 000208 ( Main/Exploration ); précédent : 000207; suivant : 000209Predictive factors of severe multilobar pneumonia and shock in patients with influenza.
Auteurs : Susana Garcia Gutierrez [Espagne] ; José Maria Quintana ; Maretva Baricot ; Amaia Bilbao ; Alberto Capelastegui ; Carlos Gustavo Cilla Eguiluz ; Angela Domínguez ; Jesús Castilla ; Pere Godoy ; Miguel Delgado-Rodríguez ; Núria Soldevila ; Jenaro Astray ; José María Mayoral ; Vicente Martín ; Fernando González-Candelas ; Juan Carlos Galán ; Sonia Tamames ; Ady Angélica Castro-Acosta ; Olatz Garín ; Tomás PumarolaSource :
- Emergency medicine journal : EMJ [ 1472-0213 ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Aire sous la courbe (MeSH), Analyse multifactorielle (MeSH), Choc (étiologie), Comorbidité (MeSH), Espagne (MeSH), Facteurs de risque (MeSH), Femelle (MeSH), Grippe humaine (complications), Grippe humaine (virologie), Humains (MeSH), Mâle (MeSH), Pneumopathie infectieuse (étiologie), Sous-type H1N1 du virus de la grippe A (isolement et purification), Sujet âgé (MeSH), Valeur prédictive des tests (MeSH), État de santé (MeSH), Études prospectives (MeSH).
- MESH :
- isolement et purification : Sous-type H1N1 du virus de la grippe A.
- virologie : Grippe humaine.
- étiologie : Choc, Pneumopathie infectieuse.
- Adulte, Adulte d'âge moyen, Aire sous la courbe, Analyse multifactorielle, Comorbidité, Espagne, Facteurs de risque, Femelle, Grippe humaine, Humains, Mâle, Sujet âgé, Valeur prédictive des tests, État de santé, Études prospectives.
- Wicri :
- geographic : Espagne.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Area Under Curve (MeSH), Comorbidity (MeSH), Female (MeSH), Health Status (MeSH), Humans (MeSH), Influenza A Virus, H1N1 Subtype (isolation & purification), Influenza, Human (complications), Influenza, Human (virology), Male (MeSH), Middle Aged (MeSH), Multivariate Analysis (MeSH), Pneumonia (etiology), Predictive Value of Tests (MeSH), Prospective Studies (MeSH), Risk Factors (MeSH), Shock (etiology), Spain (MeSH).
- MESH :
- geographic : Spain.
- complications : Influenza, Human.
- etiology : Pneumonia, Shock.
- isolation & purification : Influenza A Virus, H1N1 Subtype.
- virology : Influenza, Human.
- Adult, Aged, Area Under Curve, Comorbidity, Female, Health Status, Humans, Male, Middle Aged, Multivariate Analysis, Predictive Value of Tests, Prospective Studies, Risk Factors.
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-confirmed 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 influenza 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.
DOI: 10.1136/emermed-2012-202081
PubMed: 23449891
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Galdakao, Bizkaia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Unidad de Investigación, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Hospital Galdakao-Usansolo (Osakidetza), , Galdakao, Bizkaia</wicri:regionArea><wicri:noRegion>Bizkaia</wicri:noRegion></affiliation></author><author><name sortKey="Quintana, Jose Maria" sort="Quintana, Jose Maria" uniqKey="Quintana J" first="José Maria" last="Quintana">José Maria Quintana</name></author><author><name sortKey="Baricot, Maretva" sort="Baricot, Maretva" uniqKey="Baricot M" first="Maretva" last="Baricot">Maretva Baricot</name></author><author><name sortKey="Bilbao, Amaia" sort="Bilbao, Amaia" uniqKey="Bilbao A" first="Amaia" last="Bilbao">Amaia Bilbao</name></author><author><name sortKey="Capelastegui, Alberto" sort="Capelastegui, Alberto" uniqKey="Capelastegui A" first="Alberto" last="Capelastegui">Alberto Capelastegui</name></author><author><name sortKey="Cilla Eguiluz, Carlos Gustavo" sort="Cilla Eguiluz, Carlos Gustavo" uniqKey="Cilla Eguiluz C" first="Carlos Gustavo" last="Cilla Eguiluz">Carlos Gustavo Cilla Eguiluz</name></author><author><name sortKey="Dominguez, Angela" sort="Dominguez, Angela" uniqKey="Dominguez A" first="Angela" last="Domínguez">Angela Domínguez</name></author><author><name sortKey="Castilla, Jesus" sort="Castilla, Jesus" uniqKey="Castilla J" first="Jesús" last="Castilla">Jesús Castilla</name></author><author><name sortKey="Godoy, Pere" sort="Godoy, Pere" uniqKey="Godoy P" first="Pere" last="Godoy">Pere Godoy</name></author><author><name sortKey="Delgado Rodriguez, Miguel" sort="Delgado Rodriguez, Miguel" uniqKey="Delgado Rodriguez M" first="Miguel" last="Delgado-Rodríguez">Miguel Delgado-Rodríguez</name></author><author><name sortKey="Soldevila, Nuria" sort="Soldevila, Nuria" uniqKey="Soldevila N" first="Núria" last="Soldevila">Núria Soldevila</name></author><author><name sortKey="Astray, Jenaro" sort="Astray, Jenaro" uniqKey="Astray J" first="Jenaro" last="Astray">Jenaro Astray</name></author><author><name sortKey="Mayoral, Jose Maria" sort="Mayoral, Jose Maria" uniqKey="Mayoral J" first="José María" last="Mayoral">José María Mayoral</name></author><author><name sortKey="Martin, Vicente" sort="Martin, Vicente" uniqKey="Martin V" first="Vicente" last="Martín">Vicente Martín</name></author><author><name sortKey="Gonzalez Candelas, Fernando" sort="Gonzalez Candelas, Fernando" uniqKey="Gonzalez Candelas F" first="Fernando" last="González-Candelas">Fernando González-Candelas</name></author><author><name sortKey="Galan, Juan Carlos" sort="Galan, Juan Carlos" uniqKey="Galan J" first="Juan Carlos" last="Galán">Juan Carlos Galán</name></author><author><name sortKey="Tamames, Sonia" sort="Tamames, Sonia" uniqKey="Tamames S" first="Sonia" last="Tamames">Sonia Tamames</name></author><author><name sortKey="Castro Acosta, Ady Angelica" sort="Castro Acosta, Ady Angelica" uniqKey="Castro Acosta A" first="Ady Angélica" last="Castro-Acosta">Ady Angélica Castro-Acosta</name></author><author><name sortKey="Garin, Olatz" sort="Garin, Olatz" uniqKey="Garin O" first="Olatz" last="Garín">Olatz Garín</name></author><author><name sortKey="Pumarola, Tomas" sort="Pumarola, Tomas" uniqKey="Pumarola T" first="Tomás" last="Pumarola">Tomás Pumarola</name></author></analytic><series><title level="j">Emergency medicine journal : EMJ</title><idno type="eISSN">1472-0213</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Area Under Curve (MeSH)</term><term>Comorbidity (MeSH)</term><term>Female (MeSH)</term><term>Health Status (MeSH)</term><term>Humans (MeSH)</term><term>Influenza A Virus, H1N1 Subtype (isolation & purification)</term><term>Influenza, Human (complications)</term><term>Influenza, Human (virology)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Multivariate Analysis (MeSH)</term><term>Pneumonia (etiology)</term><term>Predictive Value of Tests (MeSH)</term><term>Prospective Studies (MeSH)</term><term>Risk Factors (MeSH)</term><term>Shock (etiology)</term><term>Spain (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Aire sous la courbe (MeSH)</term><term>Analyse multifactorielle (MeSH)</term><term>Choc (étiologie)</term><term>Comorbidité (MeSH)</term><term>Espagne (MeSH)</term><term>Facteurs de risque (MeSH)</term><term>Femelle (MeSH)</term><term>Grippe humaine (complications)</term><term>Grippe humaine (virologie)</term><term>Humains (MeSH)</term><term>Mâle (MeSH)</term><term>Pneumopathie infectieuse (étiologie)</term><term>Sous-type H1N1 du virus de la grippe A (isolement et purification)</term><term>Sujet âgé (MeSH)</term><term>Valeur prédictive des tests (MeSH)</term><term>État de santé (MeSH)</term><term>Études prospectives (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Spain</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Pneumonia</term><term>Shock</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Influenza A Virus, H1N1 Subtype</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Sous-type H1N1 du virus de la grippe A</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Choc</term><term>Pneumopathie infectieuse</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Area Under Curve</term><term>Comorbidity</term><term>Female</term><term>Health Status</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Multivariate Analysis</term><term>Predictive Value of Tests</term><term>Prospective Studies</term><term>Risk Factors</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Aire sous la courbe</term><term>Analyse multifactorielle</term><term>Comorbidité</term><term>Espagne</term><term>Facteurs de risque</term><term>Femelle</term><term>Grippe humaine</term><term>Humains</term><term>Mâle</term><term>Sujet âgé</term><term>Valeur prédictive des tests</term><term>État de santé</term><term>Études prospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Espagne</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>PURPOSE</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Laboratory-confirmed 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 influenza 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).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>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.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">23449891</PMID><DateCompleted><Year>2015</Year><Month>02</Month><Day>19</Day></DateCompleted><DateRevised><Year>2014</Year><Month>03</Month><Day>13</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1472-0213</ISSN><JournalIssue CitedMedium="Internet"><Volume>31</Volume><Issue>4</Issue><PubDate><Year>2014</Year><Month>Apr</Month></PubDate></JournalIssue><Title>Emergency medicine journal : EMJ</Title><ISOAbbreviation>Emerg Med J</ISOAbbreviation></Journal><ArticleTitle>Predictive factors of severe multilobar pneumonia and shock in patients with influenza.</ArticleTitle><Pagination><MedlinePgn>301-7</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1136/emermed-2012-202081</ELocationID><Abstract><AbstractText Label="PURPOSE" NlmCategory="OBJECTIVE">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.</AbstractText><AbstractText Label="METHODS" NlmCategory="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.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Laboratory-confirmed 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 influenza 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).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="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.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Garcia Gutierrez</LastName><ForeName>Susana</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Unidad de Investigación, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Hospital Galdakao-Usansolo (Osakidetza), , Galdakao, Bizkaia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Quintana</LastName><ForeName>José Maria</ForeName><Initials>JM</Initials></Author><Author ValidYN="Y"><LastName>Baricot</LastName><ForeName>Maretva</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Bilbao</LastName><ForeName>Amaia</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Capelastegui</LastName><ForeName>Alberto</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Cilla Eguiluz</LastName><ForeName>Carlos Gustavo</ForeName><Initials>CG</Initials></Author><Author ValidYN="Y"><LastName>Domínguez</LastName><ForeName>Angela</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Castilla</LastName><ForeName>Jesús</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Godoy</LastName><ForeName>Pere</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Delgado-Rodríguez</LastName><ForeName>Miguel</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Soldevila</LastName><ForeName>Núria</ForeName><Initials>N</Initials></Author><Author ValidYN="Y"><LastName>Astray</LastName><ForeName>Jenaro</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Mayoral</LastName><ForeName>José María</ForeName><Initials>JM</Initials></Author><Author ValidYN="Y"><LastName>Martín</LastName><ForeName>Vicente</ForeName><Initials>V</Initials></Author><Author ValidYN="Y"><LastName>González-Candelas</LastName><ForeName>Fernando</ForeName><Initials>F</Initials></Author><Author ValidYN="Y"><LastName>Galán</LastName><ForeName>Juan Carlos</ForeName><Initials>JC</Initials></Author><Author ValidYN="Y"><LastName>Tamames</LastName><ForeName>Sonia</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Castro-Acosta</LastName><ForeName>Ady Angélica</ForeName><Initials>AA</Initials></Author><Author ValidYN="Y"><LastName>Garín</LastName><ForeName>Olatz</ForeName><Initials>O</Initials></Author><Author ValidYN="Y"><LastName>Pumarola</LastName><ForeName>Tomás</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><CollectiveName>CIBERESP Cases and Controls in Pandemic Influenza Working Group, Spain</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2013</Year><Month>02</Month><Day>28</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Emerg Med J</MedlineTA><NlmUniqueID>100963089</NlmUniqueID><ISSNLinking>1472-0205</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" 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