Timing of oseltamivir administration and outcomes in hospitalized adults with pandemic 2009 influenza A(H1N1) virus infection.
Identifieur interne : 000377 ( Main/Exploration ); précédent : 000376; suivant : 000378Timing of oseltamivir administration and outcomes in hospitalized adults with pandemic 2009 influenza A(H1N1) virus infection.
Auteurs : Diego Viasus [Espagne] ; José Ram N Pa O-Pardo [Espagne] ; Jer Nimo Pach N [Espagne] ; Melchor Riera [Espagne] ; Francisco L Pez-Medrano [Espagne] ; Antoni Payeras [Espagne] ; M Carmen Fari As [Espagne] ; Asunci N Moreno [Espagne] ; Jesús Rodríguez-Ba O [Espagne] ; José Antonio Oteo [Espagne] ; Lucia Ortega [Espagne] ; Julián Torre-Cisneros [Espagne] ; Ferrán Segura [Espagne] ; Jordi Carratalà [Espagne]Source :
- Chest [ 1931-3543 ] ; 2011.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen (MeSH), Antiviraux (administration et posologie), Antiviraux (usage thérapeutique), Durée du séjour (MeSH), Espagne (MeSH), Facteurs temps (MeSH), Femelle (MeSH), Grippe humaine (mortalité), Grippe humaine (traitement médicamenteux), Grippe humaine (épidémiologie), Humains (MeSH), Modèles logistiques (MeSH), Mortalité hospitalière (MeSH), Mâle (MeSH), Oséltamivir (administration et posologie), Oséltamivir (usage thérapeutique), Pandémies (MeSH), Patients hospitalisés (MeSH), Résultat thérapeutique (MeSH), Sous-type H1N1 du virus de la grippe A (MeSH), Ventilation artificielle (MeSH), Études de cohortes (MeSH), Études prospectives (MeSH), Études rétrospectives (MeSH).
- MESH :
- administration et posologie : Antiviraux, Oséltamivir.
- mortalité : Grippe humaine.
- traitement médicamenteux : Grippe humaine.
- usage thérapeutique : Antiviraux, Oséltamivir.
- épidémiologie : Grippe humaine.
- Adulte d'âge moyen, Durée du séjour, Espagne, Facteurs temps, Femelle, Humains, Modèles logistiques, Mortalité hospitalière, Mâle, Pandémies, Patients hospitalisés, Résultat thérapeutique, Sous-type H1N1 du virus de la grippe A, Ventilation artificielle, Études de cohortes, Études prospectives, Études rétrospectives.
- Wicri :
- geographic : Espagne.
English descriptors
- KwdEn :
- Antiviral Agents (administration & dosage), Antiviral Agents (therapeutic use), Cohort Studies (MeSH), Female (MeSH), Hospital Mortality (MeSH), Humans (MeSH), Influenza A Virus, H1N1 Subtype (MeSH), Influenza, Human (drug therapy), Influenza, Human (epidemiology), Influenza, Human (mortality), Inpatients (MeSH), Length of Stay (MeSH), Logistic Models (MeSH), Male (MeSH), Middle Aged (MeSH), Oseltamivir (administration & dosage), Oseltamivir (therapeutic use), Pandemics (MeSH), Prospective Studies (MeSH), Respiration, Artificial (MeSH), Retrospective Studies (MeSH), Spain (MeSH), Time Factors (MeSH), Treatment Outcome (MeSH).
- MESH :
- chemical , administration & dosage : Antiviral Agents, Oseltamivir.
- chemical , therapeutic use : Antiviral Agents, Oseltamivir.
- geographic : Spain.
- drug therapy : Influenza, Human.
- epidemiology : Influenza, Human.
- mortality : Influenza, Human.
- Cohort Studies, Female, Hospital Mortality, Humans, Influenza A Virus, H1N1 Subtype, Inpatients, Length of Stay, Logistic Models, Male, Middle Aged, Pandemics, Prospective Studies, Respiration, Artificial, Retrospective Studies, Time Factors, Treatment Outcome.
Abstract
BACKGROUND
Data on the clinical effectiveness of oseltamivir in patients with pandemic 2009 influenza A(H1N1) (A[H1N1]) virus infection are scarce. We aimed to determine the effect of timing of oseltamivir administration on outcomes in hospitalized adults with A(H1N1).
METHODS
Observational analysis of a prospective cohort of adults hospitalized with laboratory-confirmed A(H1N1) was performed at 13 Spanish hospitals. Time from onset of symptoms to oseltamivir administration was the independent variable. Outcomes were duration of fever, hospital length of stay (LOS), need for mechanical ventilation, and mortality during hospitalization. Multivariate logistic regression was used to describe the association between the independent variable and the outcomes.
RESULTS
Five hundred thirty-eight hospitalized patients with A(H1N1) were studied. The median time from onset of symptoms to oseltamivir administration was 3 days (interquartile range [IQR], 2-5 days). With regard to outcomes, the median duration of fever was 2 days (IQR, 1-3 days), the median LOS was 5 days (IQR, 3-8 days), 49 patients (9.1%) underwent mechanical ventilation, and 11 patients (2%) died during hospitalization. In univariate analysis, prolonged duration of fever (above the median), prolonged LOS (above the median), need for mechanical ventilation, and mortality all increased with time to oseltamivir administration (χ(2) test for trend P = .001, P ≤ .001, P = .008, and P = .001, respectively). After adjustment for confounding factors, time from onset of symptoms to oseltamivir administration (+ 1-day increase) was associated with a prolonged duration of fever (OR, 1.10; 95% CI, 1.02-1.19), prolonged LOS (OR, 1.07; 95% CI, 1.00-1.15), and higher mortality (OR, 1.20; 95% CI, 1.06-1.35).
CONCLUSIONS
Timely oseltamivir administration has a beneficial effect on outcomes in hospitalized adults with A(H1N1), even in those who are admitted beyond 48 h after onset of symptoms.
DOI: 10.1378/chest.10-2792
PubMed: 21415133
Affiliations:
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Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital San Pedro-CIBIR, Logroño</wicri:regionArea><wicri:noRegion>Logroño</wicri:noRegion></affiliation></author><author><name sortKey="Ortega, Lucia" sort="Ortega, Lucia" uniqKey="Ortega L" first="Lucia" last="Ortega">Lucia Ortega</name><affiliation wicri:level="3"><nlm:affiliation>SCIAS-Hospital de Barcelona, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>SCIAS-Hospital de Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Torre Cisneros, Julian" sort="Torre Cisneros, Julian" uniqKey="Torre Cisneros J" first="Julián" last="Torre-Cisneros">Julián Torre-Cisneros</name><affiliation wicri:level="1"><nlm:affiliation>Hospital Universitario Reina Sofía-IMIBIC, University of Córdoba, Córdoba, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Universitario Reina Sofía-IMIBIC, University of Córdoba, Córdoba</wicri:regionArea><wicri:noRegion>Córdoba</wicri:noRegion></affiliation></author><author><name sortKey="Segura, Ferran" sort="Segura, Ferran" uniqKey="Segura F" first="Ferrán" last="Segura">Ferrán Segura</name><affiliation wicri:level="1"><nlm:affiliation>Hospital Parc Tauli, Sabadell, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Parc Tauli, Sabadell</wicri:regionArea><wicri:noRegion>Sabadell</wicri:noRegion></affiliation></author><author><name sortKey="Carratala, Jordi" sort="Carratala, Jordi" uniqKey="Carratala J" first="Jordi" last="Carratalà">Jordi Carratalà</name><affiliation wicri:level="3"><nlm:affiliation>Departments of Infectious Diseases from the Hospital Universitari de Bellvitge-IDIBELL, University of Barcelona, Barcelona, Spain. Electronic address: jcarratala@ub.edu.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Departments of Infectious Diseases from the Hospital Universitari de Bellvitge-IDIBELL, University of Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2011">2011</date><idno type="RBID">pubmed:21415133</idno><idno type="pmid">21415133</idno><idno type="doi">10.1378/chest.10-2792</idno><idno type="wicri:Area/Main/Corpus">00390</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">00390</idno><idno type="wicri:Area/Main/Curation">000390</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000390</idno><idno 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uniqKey="Pa O Pardo J" first="José Ram N" last="Pa O-Pardo">José Ram N Pa O-Pardo</name><affiliation wicri:level="3"><nlm:affiliation>Hospital Universitario La Paz-IDIPAZ, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Universitario La Paz-IDIPAZ, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Pach N, Jer Nimo" sort="Pach N, Jer Nimo" uniqKey="Pach N J" first="Jer Nimo" last="Pach N">Jer Nimo Pach N</name><affiliation wicri:level="1"><nlm:affiliation>Hospital Universitario Virgen del Rocío, Sevilla, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Universitario Virgen del Rocío, Sevilla</wicri:regionArea><wicri:noRegion>Sevilla</wicri:noRegion></affiliation></author><author><name sortKey="Riera, Melchor" sort="Riera, Melchor" uniqKey="Riera M" first="Melchor" last="Riera">Melchor Riera</name><affiliation wicri:level="1"><nlm:affiliation>Hospital Universitario Son Dureta, Palma de Mallorca, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Universitario Son Dureta, Palma de Mallorca</wicri:regionArea><wicri:noRegion>Palma de Mallorca</wicri:noRegion></affiliation></author><author><name sortKey="L Pez Medrano, Francisco" sort="L Pez Medrano, Francisco" uniqKey="L Pez Medrano F" first="Francisco" last="L Pez-Medrano">Francisco L Pez-Medrano</name><affiliation wicri:level="3"><nlm:affiliation>Hospital Universitario 12 de Octubre, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Universitario 12 de Octubre, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Payeras, Antoni" sort="Payeras, Antoni" uniqKey="Payeras A" first="Antoni" last="Payeras">Antoni Payeras</name><affiliation wicri:level="1"><nlm:affiliation>Hospital Son Llàtzer, Palma de Mallorca, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Son Llàtzer, Palma de Mallorca</wicri:regionArea><wicri:noRegion>Palma de Mallorca</wicri:noRegion></affiliation></author><author><name sortKey="Fari As, M Carmen" sort="Fari As, M Carmen" uniqKey="Fari As M" first="M Carmen" last="Fari As">M Carmen Fari As</name><affiliation wicri:level="1"><nlm:affiliation>Hospital Universitario Marqués de Valdecilla, Santander, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Universitario Marqués de Valdecilla, Santander</wicri:regionArea><wicri:noRegion>Santander</wicri:noRegion></affiliation></author><author><name sortKey="Moreno, Asunci N" sort="Moreno, Asunci N" uniqKey="Moreno A" first="Asunci N" last="Moreno">Asunci N Moreno</name><affiliation wicri:level="3"><nlm:affiliation>Hospital Universitario Clinic, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Universitario Clinic, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Rodriguez Ba O, Jesus" sort="Rodriguez Ba O, Jesus" uniqKey="Rodriguez Ba O J" first="Jesús" last="Rodríguez-Ba O">Jesús Rodríguez-Ba O</name><affiliation wicri:level="1"><nlm:affiliation>Hospital Universitario Virgen Macarena, Sevilla, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Universitario Virgen Macarena, Sevilla</wicri:regionArea><wicri:noRegion>Sevilla</wicri:noRegion></affiliation></author><author><name sortKey="Oteo, Jose Antonio" sort="Oteo, Jose Antonio" uniqKey="Oteo J" first="José Antonio" last="Oteo">José Antonio Oteo</name><affiliation wicri:level="1"><nlm:affiliation>Hospital San Pedro-CIBIR, Logroño, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital San Pedro-CIBIR, Logroño</wicri:regionArea><wicri:noRegion>Logroño</wicri:noRegion></affiliation></author><author><name sortKey="Ortega, Lucia" sort="Ortega, Lucia" uniqKey="Ortega L" first="Lucia" last="Ortega">Lucia Ortega</name><affiliation wicri:level="3"><nlm:affiliation>SCIAS-Hospital de Barcelona, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>SCIAS-Hospital de Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Torre Cisneros, Julian" sort="Torre Cisneros, Julian" uniqKey="Torre Cisneros J" first="Julián" last="Torre-Cisneros">Julián Torre-Cisneros</name><affiliation wicri:level="1"><nlm:affiliation>Hospital Universitario Reina Sofía-IMIBIC, University of Córdoba, Córdoba, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Universitario Reina Sofía-IMIBIC, University of Córdoba, Córdoba</wicri:regionArea><wicri:noRegion>Córdoba</wicri:noRegion></affiliation></author><author><name sortKey="Segura, Ferran" sort="Segura, Ferran" uniqKey="Segura F" first="Ferrán" last="Segura">Ferrán Segura</name><affiliation wicri:level="1"><nlm:affiliation>Hospital Parc Tauli, Sabadell, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Parc Tauli, Sabadell</wicri:regionArea><wicri:noRegion>Sabadell</wicri:noRegion></affiliation></author><author><name sortKey="Carratala, Jordi" sort="Carratala, Jordi" uniqKey="Carratala J" first="Jordi" last="Carratalà">Jordi Carratalà</name><affiliation wicri:level="3"><nlm:affiliation>Departments of Infectious Diseases from the Hospital Universitari de Bellvitge-IDIBELL, University of Barcelona, Barcelona, Spain. Electronic address: jcarratala@ub.edu.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Departments of Infectious Diseases from the Hospital Universitari de Bellvitge-IDIBELL, University of Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author></analytic><series><title level="j">Chest</title><idno type="eISSN">1931-3543</idno><imprint><date when="2011" type="published">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antiviral Agents (administration & dosage)</term><term>Antiviral Agents (therapeutic use)</term><term>Cohort Studies (MeSH)</term><term>Female (MeSH)</term><term>Hospital Mortality (MeSH)</term><term>Humans (MeSH)</term><term>Influenza A Virus, H1N1 Subtype (MeSH)</term><term>Influenza, Human (drug therapy)</term><term>Influenza, Human (epidemiology)</term><term>Influenza, Human (mortality)</term><term>Inpatients (MeSH)</term><term>Length of Stay (MeSH)</term><term>Logistic Models (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Oseltamivir (administration & dosage)</term><term>Oseltamivir (therapeutic use)</term><term>Pandemics (MeSH)</term><term>Prospective Studies (MeSH)</term><term>Respiration, Artificial (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>Spain (MeSH)</term><term>Time Factors (MeSH)</term><term>Treatment Outcome (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term><term>Antiviraux (administration et posologie)</term><term>Antiviraux (usage thérapeutique)</term><term>Durée du séjour (MeSH)</term><term>Espagne (MeSH)</term><term>Facteurs temps (MeSH)</term><term>Femelle (MeSH)</term><term>Grippe humaine (mortalité)</term><term>Grippe humaine (traitement médicamenteux)</term><term>Grippe humaine (épidémiologie)</term><term>Humains (MeSH)</term><term>Modèles logistiques (MeSH)</term><term>Mortalité hospitalière (MeSH)</term><term>Mâle (MeSH)</term><term>Oséltamivir (administration et posologie)</term><term>Oséltamivir (usage thérapeutique)</term><term>Pandémies (MeSH)</term><term>Patients hospitalisés (MeSH)</term><term>Résultat thérapeutique (MeSH)</term><term>Sous-type H1N1 du virus de la grippe A (MeSH)</term><term>Ventilation artificielle (MeSH)</term><term>Études de cohortes (MeSH)</term><term>Études prospectives (MeSH)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antiviral Agents</term><term>Oseltamivir</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiviral Agents</term><term>Oseltamivir</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Spain</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Antiviraux</term><term>Oséltamivir</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antiviraux</term><term>Oséltamivir</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Cohort Studies</term><term>Female</term><term>Hospital Mortality</term><term>Humans</term><term>Influenza A Virus, H1N1 Subtype</term><term>Inpatients</term><term>Length of Stay</term><term>Logistic Models</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term><term>Prospective Studies</term><term>Respiration, Artificial</term><term>Retrospective Studies</term><term>Time Factors</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Durée du séjour</term><term>Espagne</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Modèles logistiques</term><term>Mortalité hospitalière</term><term>Mâle</term><term>Pandémies</term><term>Patients hospitalisés</term><term>Résultat thérapeutique</term><term>Sous-type H1N1 du virus de la grippe A</term><term>Ventilation artificielle</term><term>Études de cohortes</term><term>Études prospectives</term><term>Études rétrospectives</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>BACKGROUND</b></p><p>Data on the clinical effectiveness of oseltamivir in patients with pandemic 2009 influenza A(H1N1) (A[H1N1]) virus infection are scarce. We aimed to determine the effect of timing of oseltamivir administration on outcomes in hospitalized adults with A(H1N1).</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Observational analysis of a prospective cohort of adults hospitalized with laboratory-confirmed A(H1N1) was performed at 13 Spanish hospitals. Time from onset of symptoms to oseltamivir administration was the independent variable. Outcomes were duration of fever, hospital length of stay (LOS), need for mechanical ventilation, and mortality during hospitalization. Multivariate logistic regression was used to describe the association between the independent variable and the outcomes.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Five hundred thirty-eight hospitalized patients with A(H1N1) were studied. The median time from onset of symptoms to oseltamivir administration was 3 days (interquartile range [IQR], 2-5 days). With regard to outcomes, the median duration of fever was 2 days (IQR, 1-3 days), the median LOS was 5 days (IQR, 3-8 days), 49 patients (9.1%) underwent mechanical ventilation, and 11 patients (2%) died during hospitalization. In univariate analysis, prolonged duration of fever (above the median), prolonged LOS (above the median), need for mechanical ventilation, and mortality all increased with time to oseltamivir administration (χ(2) test for trend P = .001, P ≤ .001, P = .008, and P = .001, respectively). After adjustment for confounding factors, time from onset of symptoms to oseltamivir administration (+ 1-day increase) was associated with a prolonged duration of fever (OR, 1.10; 95% CI, 1.02-1.19), prolonged LOS (OR, 1.07; 95% CI, 1.00-1.15), and higher mortality (OR, 1.20; 95% CI, 1.06-1.35).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Timely oseltamivir administration has a beneficial effect on outcomes in hospitalized adults with A(H1N1), even in those who are admitted beyond 48 h after onset of symptoms.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">21415133</PMID><DateCompleted><Year>2011</Year><Month>12</Month><Day>07</Day></DateCompleted><DateRevised><Year>2017</Year><Month>05</Month><Day>28</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1931-3543</ISSN><JournalIssue CitedMedium="Internet"><Volume>140</Volume><Issue>4</Issue><PubDate><Year>2011</Year><Month>Oct</Month></PubDate></JournalIssue><Title>Chest</Title><ISOAbbreviation>Chest</ISOAbbreviation></Journal><ArticleTitle>Timing of oseltamivir administration and outcomes in hospitalized adults with pandemic 2009 influenza A(H1N1) virus infection.</ArticleTitle><Pagination><MedlinePgn>1025-1032</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0012-3692(11)60540-0</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1378/chest.10-2792</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Data on the clinical effectiveness of oseltamivir in patients with pandemic 2009 influenza A(H1N1) (A[H1N1]) virus infection are scarce. We aimed to determine the effect of timing of oseltamivir administration on outcomes in hospitalized adults with A(H1N1).</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Observational analysis of a prospective cohort of adults hospitalized with laboratory-confirmed A(H1N1) was performed at 13 Spanish hospitals. Time from onset of symptoms to oseltamivir administration was the independent variable. Outcomes were duration of fever, hospital length of stay (LOS), need for mechanical ventilation, and mortality during hospitalization. Multivariate logistic regression was used to describe the association between the independent variable and the outcomes.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Five hundred thirty-eight hospitalized patients with A(H1N1) were studied. The median time from onset of symptoms to oseltamivir administration was 3 days (interquartile range [IQR], 2-5 days). With regard to outcomes, the median duration of fever was 2 days (IQR, 1-3 days), the median LOS was 5 days (IQR, 3-8 days), 49 patients (9.1%) underwent mechanical ventilation, and 11 patients (2%) died during hospitalization. In univariate analysis, prolonged duration of fever (above the median), prolonged LOS (above the median), need for mechanical ventilation, and mortality all increased with time to oseltamivir administration (χ(2) test for trend P = .001, P ≤ .001, P = .008, and P = .001, respectively). After adjustment for confounding factors, time from onset of symptoms to oseltamivir administration (+ 1-day increase) was associated with a prolonged duration of fever (OR, 1.10; 95% CI, 1.02-1.19), prolonged LOS (OR, 1.07; 95% CI, 1.00-1.15), and higher mortality (OR, 1.20; 95% CI, 1.06-1.35).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Timely oseltamivir administration has a beneficial effect on outcomes in hospitalized adults with A(H1N1), even in those who are admitted beyond 48 h after onset of symptoms.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Viasus</LastName><ForeName>Diego</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Departments of Infectious Diseases from the Hospital Universitari de Bellvitge-IDIBELL, University of Barcelona, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Paño-Pardo</LastName><ForeName>José Ramón</ForeName><Initials>JR</Initials><AffiliationInfo><Affiliation>Hospital Universitario La Paz-IDIPAZ, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pachón</LastName><ForeName>Jerónimo</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Hospital Universitario Virgen del Rocío, Sevilla, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Riera</LastName><ForeName>Melchor</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Hospital Universitario Son Dureta, Palma de Mallorca, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>López-Medrano</LastName><ForeName>Francisco</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Hospital Universitario 12 de Octubre, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Payeras</LastName><ForeName>Antoni</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Hospital Son Llàtzer, Palma de Mallorca, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fariñas</LastName><ForeName>M Carmen</ForeName><Initials>MC</Initials><AffiliationInfo><Affiliation>Hospital Universitario Marqués de Valdecilla, Santander, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Moreno</LastName><ForeName>Asunción</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Hospital Universitario Clinic, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rodríguez-Baño</LastName><ForeName>Jesús</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Hospital Universitario Virgen Macarena, Sevilla, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Oteo</LastName><ForeName>José Antonio</ForeName><Initials>JA</Initials><AffiliationInfo><Affiliation>Hospital San Pedro-CIBIR, Logroño, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ortega</LastName><ForeName>Lucia</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>SCIAS-Hospital de Barcelona, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Torre-Cisneros</LastName><ForeName>Julián</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Hospital Universitario Reina Sofía-IMIBIC, University of Córdoba, Córdoba, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Segura</LastName><ForeName>Ferrán</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Hospital Parc Tauli, Sabadell, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Carratalà</LastName><ForeName>Jordi</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Departments of Infectious Diseases from the Hospital Universitari de Bellvitge-IDIBELL, University of Barcelona, Barcelona, Spain. Electronic address: jcarratala@ub.edu.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>Novel Infl uenza A(H1N1) Study Group of the Spanish Network for Research in Infectious Diseases (REIPI)</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2011</Year><Month>03</Month><Day>17</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Chest</MedlineTA><NlmUniqueID>0231335</NlmUniqueID><ISSNLinking>0012-3692</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000998">Antiviral Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>20O93L6F9H</RegistryNumber><NameOfSubstance UI="D053139">Oseltamivir</NameOfSubstance></Chemical></ChemicalList><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000998" MajorTopicYN="N">Antiviral Agents</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017052" MajorTopicYN="N">Hospital Mortality</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D053118" MajorTopicYN="Y">Influenza A Virus, H1N1 Subtype</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007297" MajorTopicYN="Y">Inpatients</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007902" MajorTopicYN="N">Length of Stay</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016015" MajorTopicYN="N">Logistic Models</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D053139" MajorTopicYN="N">Oseltamivir</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="Y">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012121" MajorTopicYN="N">Respiration, Artificial</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013030" MajorTopicYN="N" Type="Geographic">Spain</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2011</Year><Month>3</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2011</Year><Month>3</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2011</Year><Month>12</Month><Day>13</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">21415133</ArticleId><ArticleId IdType="pii">S0012-3692(11)60540-0</ArticleId><ArticleId IdType="doi">10.1378/chest.10-2792</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Espagne</li></country><region><li>Catalogne</li><li>Communauté de Madrid</li></region><settlement><li>Barcelone</li><li>Madrid</li></settlement></list><tree><country name="Espagne"><region name="Catalogne"><name sortKey="Viasus, Diego" sort="Viasus, Diego" uniqKey="Viasus D" first="Diego" last="Viasus">Diego Viasus</name></region><name sortKey="Carratala, Jordi" sort="Carratala, Jordi" uniqKey="Carratala J" first="Jordi" last="Carratalà">Jordi Carratalà</name><name sortKey="Fari As, M Carmen" sort="Fari As, M Carmen" uniqKey="Fari As M" first="M Carmen" last="Fari As">M Carmen Fari As</name><name sortKey="L Pez Medrano, Francisco" sort="L Pez Medrano, Francisco" uniqKey="L Pez Medrano F" first="Francisco" last="L Pez-Medrano">Francisco L Pez-Medrano</name><name sortKey="Moreno, Asunci N" sort="Moreno, Asunci N" uniqKey="Moreno A" first="Asunci N" last="Moreno">Asunci N Moreno</name><name sortKey="Ortega, Lucia" sort="Ortega, Lucia" uniqKey="Ortega L" first="Lucia" last="Ortega">Lucia Ortega</name><name sortKey="Oteo, Jose Antonio" sort="Oteo, Jose Antonio" uniqKey="Oteo J" first="José Antonio" last="Oteo">José Antonio Oteo</name><name sortKey="Pa O Pardo, Jose Ram N" sort="Pa O Pardo, Jose Ram N" uniqKey="Pa O Pardo J" first="José Ram N" last="Pa O-Pardo">José Ram N Pa O-Pardo</name><name sortKey="Pach N, Jer Nimo" sort="Pach N, Jer Nimo" uniqKey="Pach N J" first="Jer Nimo" last="Pach N">Jer Nimo Pach N</name><name sortKey="Payeras, Antoni" sort="Payeras, Antoni" uniqKey="Payeras A" first="Antoni" last="Payeras">Antoni Payeras</name><name sortKey="Riera, Melchor" sort="Riera, Melchor" uniqKey="Riera M" first="Melchor" last="Riera">Melchor Riera</name><name sortKey="Rodriguez Ba O, Jesus" sort="Rodriguez Ba O, Jesus" uniqKey="Rodriguez Ba O J" first="Jesús" last="Rodríguez-Ba O">Jesús Rodríguez-Ba O</name><name sortKey="Segura, Ferran" sort="Segura, Ferran" uniqKey="Segura F" first="Ferrán" last="Segura">Ferrán Segura</name><name sortKey="Torre Cisneros, Julian" sort="Torre Cisneros, Julian" uniqKey="Torre Cisneros J" first="Julián" last="Torre-Cisneros">Julián Torre-Cisneros</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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