The Utility of Preliminary Patient Evaluation in a Febrile Respiratory Infectious Disease Unit Outside the Emergency Department
Identifieur interne : 000631 ( Pmc/Corpus ); précédent : 000630; suivant : 000632The Utility of Preliminary Patient Evaluation in a Febrile Respiratory Infectious Disease Unit Outside the Emergency Department
Auteurs : Jun Sik Kang ; Hee Yoon ; Byung Woo Jhun ; Seong Mi Lim ; Eun Sil Ko ; Joo Hyun Park ; Sung Yeon Hwang ; Se Uk Lee ; Tae Rim Lee ; Won Chul Cha ; Tae Gun Shin ; Min Seob Sim ; Ik Joon JoSource :
- Open Forum Infectious Diseases [ 2328-8957 ] ; 2017.
Abstract
Acute respiratory illnesses are the leading cause of death from infectious diseases around the world, and occasional outbreaks of particularly virulent strains are can be public health disasters. Recently, a large outbreak of fatal Middle East respiratory syndrome-coronavirus (MERS-CoV) occurred following a single patient exposure in the emergency department (ED) of the Samsung Medical Center, a tertiary-care hospital in South Korea, which resulted in significant public health and economic burden.
After this outbreak, a febrile respiratory infectious disease unit (FRIDU) with a negative pressure ventilation system was constructed outside the emergency department (ED) in 2015, to screen for patients with contagious diseases requiring isolation.
This is a retrospective cohort study of patients who visited the ED with febrile illness between August 2015 and July 2016. Ultimately, 1562 patients who were hospitalized after FRIDU screening were analyzed. The level of isolation recommended during their screening at the FRIDU was compared with the level deemed appropriate given their final diagnosis.
Of the 1562 patients screened at the FRIDU, 198 (13%) were isolated, 194 (12%) were reverse isolated, and 1170 (75%) were not isolated. While hospitalized, 97 patients (6%) were confirmed to have a contagious disease requiring isolation, such as tuberculosis; 207 patients (13%) were confirmed to be immunocompromised and to require reverse isolation, mainly due to neutropenia; and the remaining 1258 patients (81%) did not require isolation.
The correlation coefficient for isolation consistency was 0.565 (
The initial isolation levels resulting from FRIDU screening were moderately well correlated with the isolation levels required by the final diagnosis, demonstrating the utility of pre-hospitalization screening units. However, the risks of deterioration during the screening process remain challenges.
Url:
DOI: 10.1093/ofid/ofx163.349
PubMed: NONE
PubMed Central: 5631788
Links to Exploration step
PMC:5631788Le document en format XML
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<author><name sortKey="Sim, Min Seob" sort="Sim, Min Seob" uniqKey="Sim M" first="Min Seob" last="Sim">Min Seob Sim</name>
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<author><name sortKey="Jo, Ik Joon" sort="Jo, Ik Joon" uniqKey="Jo I" first="Ik Joon" last="Jo">Ik Joon Jo</name>
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<author><name sortKey="Sik Kang, Jun" sort="Sik Kang, Jun" uniqKey="Sik Kang J" first="Jun" last="Sik Kang">Jun Sik Kang</name>
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<author><name sortKey="Yoon, Hee" sort="Yoon, Hee" uniqKey="Yoon H" first="Hee" last="Yoon">Hee Yoon</name>
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,<addr-line>Seoul</addr-line>
,<country>Korea, Republic of (South)</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Jhun, Byung Woo" sort="Jhun, Byung Woo" uniqKey="Jhun B" first="Byung Woo" last="Jhun">Byung Woo Jhun</name>
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,<addr-line>Seoul</addr-line>
,<country>Korea, Republic of (South)</country>
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</affiliation>
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<author><name sortKey="Lim, Seong Mi" sort="Lim, Seong Mi" uniqKey="Lim S" first="Seong Mi" last="Lim">Seong Mi Lim</name>
<affiliation><nlm:aff id="AF0001"><institution>Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine</institution>
,<addr-line>Seoul</addr-line>
,<country>Korea, Republic of (South)</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ko, Eun Sil" sort="Ko, Eun Sil" uniqKey="Ko E" first="Eun Sil" last="Ko">Eun Sil Ko</name>
<affiliation><nlm:aff id="AF0001"><institution>Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine</institution>
,<addr-line>Seoul</addr-line>
,<country>Korea, Republic of (South)</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Park, Joo Hyun" sort="Park, Joo Hyun" uniqKey="Park J" first="Joo Hyun" last="Park">Joo Hyun Park</name>
<affiliation><nlm:aff id="AF0001"><institution>Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine</institution>
,<addr-line>Seoul</addr-line>
,<country>Korea, Republic of (South)</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Hwang, Sung Yeon" sort="Hwang, Sung Yeon" uniqKey="Hwang S" first="Sung Yeon" last="Hwang">Sung Yeon Hwang</name>
<affiliation><nlm:aff id="AF0001"><institution>Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine</institution>
,<addr-line>Seoul</addr-line>
,<country>Korea, Republic of (South)</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lee, Se Uk" sort="Lee, Se Uk" uniqKey="Lee S" first="Se Uk" last="Lee">Se Uk Lee</name>
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,<addr-line>Seoul</addr-line>
,<country>Korea, Republic of (South)</country>
</nlm:aff>
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<author><name sortKey="Lee, Tae Rim" sort="Lee, Tae Rim" uniqKey="Lee T" first="Tae Rim" last="Lee">Tae Rim Lee</name>
<affiliation><nlm:aff id="AF0001"><institution>Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine</institution>
,<addr-line>Seoul</addr-line>
,<country>Korea, Republic of (South)</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Cha, Won Chul" sort="Cha, Won Chul" uniqKey="Cha W" first="Won Chul" last="Cha">Won Chul Cha</name>
<affiliation><nlm:aff id="AF0001"><institution>Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine</institution>
,<addr-line>Seoul</addr-line>
,<country>Korea, Republic of (South)</country>
</nlm:aff>
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<author><name sortKey="Shin, Tae Gun" sort="Shin, Tae Gun" uniqKey="Shin T" first="Tae Gun" last="Shin">Tae Gun Shin</name>
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,<country>Korea, Republic of (South)</country>
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<author><name sortKey="Sim, Min Seob" sort="Sim, Min Seob" uniqKey="Sim M" first="Min Seob" last="Sim">Min Seob Sim</name>
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,<country>Korea, Republic of (South)</country>
</nlm:aff>
</affiliation>
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<author><name sortKey="Jo, Ik Joon" sort="Jo, Ik Joon" uniqKey="Jo I" first="Ik Joon" last="Jo">Ik Joon Jo</name>
<affiliation><nlm:aff id="AF0001"><institution>Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine</institution>
,<addr-line>Seoul</addr-line>
,<country>Korea, Republic of (South)</country>
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<series><title level="j">Open Forum Infectious Diseases</title>
<idno type="eISSN">2328-8957</idno>
<imprint><date when="2017">2017</date>
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<front><div type="abstract" xml:lang="en"><title>Abstract</title>
<sec id="s1"><title>Background</title>
<p> Acute respiratory illnesses are the leading cause of death from infectious diseases around the world, and occasional outbreaks of particularly virulent strains are can be public health disasters. Recently, a large outbreak of fatal Middle East respiratory syndrome-coronavirus (MERS-CoV) occurred following a single patient exposure in the emergency department (ED) of the Samsung Medical Center, a tertiary-care hospital in South Korea, which resulted in significant public health and economic burden.</p>
<p>After this outbreak, a febrile respiratory infectious disease unit (FRIDU) with a negative pressure ventilation system was constructed outside the emergency department (ED) in 2015, to screen for patients with contagious diseases requiring isolation.</p>
</sec>
<sec id="s2"><title>Methods</title>
<p> This is a retrospective cohort study of patients who visited the ED with febrile illness between August 2015 and July 2016. Ultimately, 1562 patients who were hospitalized after FRIDU screening were analyzed. The level of isolation recommended during their screening at the FRIDU was compared with the level deemed appropriate given their final diagnosis.</p>
</sec>
<sec id="s3"><title>Results</title>
<p>Of the 1562 patients screened at the FRIDU, 198 (13%) were isolated, 194 (12%) were reverse isolated, and 1170 (75%) were not isolated. While hospitalized, 97 patients (6%) were confirmed to have a contagious disease requiring isolation, such as tuberculosis; 207 patients (13%) were confirmed to be immunocompromised and to require reverse isolation, mainly due to neutropenia; and the remaining 1258 patients (81%) did not require isolation.</p>
<p>The correlation coefficient for isolation consistency was 0.565 (<italic>P <</italic>
0.001). No serious nosocomial outbreaks of contagious diseases occurred. During FRIDU screening, 114 patients were admitted to the resuscitation zone due to clinical instability, and three of these patients died.</p>
</sec>
<sec id="s4"><title>Conclusion</title>
<p> The initial isolation levels resulting from FRIDU screening were moderately well correlated with the isolation levels required by the final diagnosis, demonstrating the utility of pre-hospitalization screening units. However, the risks of deterioration during the screening process remain challenges.</p>
</sec>
<sec id="s5"><title>Disclosures</title>
<p><bold>All authors:</bold>
No reported disclosures.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="abstract"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Open Forum Infect Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">Open Forum Infect Dis</journal-id>
<journal-id journal-id-type="publisher-id">ofid</journal-id>
<journal-title-group><journal-title>Open Forum Infectious Diseases</journal-title>
</journal-title-group>
<issn pub-type="epub">2328-8957</issn>
<publisher><publisher-name>Oxford University Press</publisher-name>
<publisher-loc>US</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmc">5631788</article-id>
<article-id pub-id-type="doi">10.1093/ofid/ofx163.349</article-id>
<article-id pub-id-type="publisher-id">ofx163.349</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Abstracts</subject>
<subj-group subj-group-type="category-toc-heading"><subject>Poster Abstract</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>The Utility of Preliminary Patient Evaluation in a Febrile Respiratory Infectious Disease Unit Outside the Emergency Department</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Sik Kang</surname>
<given-names>Jun</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="AF0001">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Yoon</surname>
<given-names>Hee</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="AF0001">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Jhun</surname>
<given-names>Byung Woo</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="AF0002">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lim</surname>
<given-names>Seong Mi</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="AF0001">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ko</surname>
<given-names>Eun Sil</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="AF0001">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Park</surname>
<given-names>Joo Hyun</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="AF0001">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hwang</surname>
<given-names>Sung Yeon</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="AF0001">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lee</surname>
<given-names>Se Uk</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="AF0001">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lee</surname>
<given-names>Tae Rim</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="AF0001">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Cha</surname>
<given-names>Won Chul</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="AF0001">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Shin</surname>
<given-names>Tae Gun</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="AF0001">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sim</surname>
<given-names>Min Seob</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="AF0001">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Jo</surname>
<given-names>Ik Joon</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="AF0001">1</xref>
</contrib>
</contrib-group>
<aff id="AF0001"><label>1</label>
<institution>Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine</institution>
,<addr-line>Seoul</addr-line>
,<country>Korea, Republic of (South)</country>
</aff>
<aff id="AF0002"><label>2</label>
<institution>Internal Medicine, Hallym University Kangnam Sacred Heart Hospital</institution>
,<addr-line>Seoul</addr-line>
,<country>Korea, Republic of (South)</country>
</aff>
<author-notes><fn id="fn-0001"><p><bold>Session:</bold>
58. HAI: The Environment</p>
<p><italic>Thursday, October 5, 2017: 12:30 PM</italic>
</p>
</fn>
</author-notes>
<pub-date pub-type="collection"><season>Fall</season>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub" iso-8601-date="2017-10-04"><day>04</day>
<month>10</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>04</day>
<month>10</month>
<year>2017</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on the . </pmc-comment>
<volume>4</volume>
<issue>Suppl 1</issue>
<issue-title>ID Week 2017 Abstracts</issue-title>
<fpage>S187</fpage>
<lpage>S188</lpage>
<permissions><copyright-statement>© The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America.</copyright-statement>
<copyright-year>2017</copyright-year>
<license license-type="cc-by-nc-nd" xlink:href="http://creativecommons.org/licenses/by-nc-nd/4.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc-nd/4.0/">http://creativecommons.org/licenses/by-nc-nd/4.0/</ext-link>
), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com</license-p>
</license>
</permissions>
<self-uri xlink:href="ofx163.349.pdf"></self-uri>
<abstract><title>Abstract</title>
<sec id="s1"><title>Background</title>
<p> Acute respiratory illnesses are the leading cause of death from infectious diseases around the world, and occasional outbreaks of particularly virulent strains are can be public health disasters. Recently, a large outbreak of fatal Middle East respiratory syndrome-coronavirus (MERS-CoV) occurred following a single patient exposure in the emergency department (ED) of the Samsung Medical Center, a tertiary-care hospital in South Korea, which resulted in significant public health and economic burden.</p>
<p>After this outbreak, a febrile respiratory infectious disease unit (FRIDU) with a negative pressure ventilation system was constructed outside the emergency department (ED) in 2015, to screen for patients with contagious diseases requiring isolation.</p>
</sec>
<sec id="s2"><title>Methods</title>
<p> This is a retrospective cohort study of patients who visited the ED with febrile illness between August 2015 and July 2016. Ultimately, 1562 patients who were hospitalized after FRIDU screening were analyzed. The level of isolation recommended during their screening at the FRIDU was compared with the level deemed appropriate given their final diagnosis.</p>
</sec>
<sec id="s3"><title>Results</title>
<p>Of the 1562 patients screened at the FRIDU, 198 (13%) were isolated, 194 (12%) were reverse isolated, and 1170 (75%) were not isolated. While hospitalized, 97 patients (6%) were confirmed to have a contagious disease requiring isolation, such as tuberculosis; 207 patients (13%) were confirmed to be immunocompromised and to require reverse isolation, mainly due to neutropenia; and the remaining 1258 patients (81%) did not require isolation.</p>
<p>The correlation coefficient for isolation consistency was 0.565 (<italic>P <</italic>
0.001). No serious nosocomial outbreaks of contagious diseases occurred. During FRIDU screening, 114 patients were admitted to the resuscitation zone due to clinical instability, and three of these patients died.</p>
</sec>
<sec id="s4"><title>Conclusion</title>
<p> The initial isolation levels resulting from FRIDU screening were moderately well correlated with the isolation levels required by the final diagnosis, demonstrating the utility of pre-hospitalization screening units. However, the risks of deterioration during the screening process remain challenges.</p>
</sec>
<sec id="s5"><title>Disclosures</title>
<p><bold>All authors:</bold>
No reported disclosures.</p>
</sec>
</abstract>
<counts><page-count count="2"></page-count>
</counts>
</article-meta>
</front>
</pmc>
</record>
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