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- Title
Management of hospitalized influenza A patients during the season 2018/19: Comparison of three medical departments and the effect on outcome and antibiotic usage.
- Authors
Karolyi, Mario; Pawelka, Erich; Kelani, Hasan; Funk, Georg Christian; Lindner, Boris; Porpaczy, Christoph; Publig, Sabine; Omid, Sara; Seitz, Tamara; Traugott, Marianna; Turner, Michael; Zoufaly, Alexander; Wenisch, Christoph
- Abstract
Summary: Background: Diagnosis and treatment of influenza patients are often provided across several medical specialties. We compared patient outcomes at an infectious diseases (ID), a rheumatology (Rheu) and a pulmonology (Pul) department. Material and methods: In this prospective observational multicenter study we included all influenza positive adults who were hospitalized and treated at flu isolation wards in three hospitals in Vienna during the season 2018/2019. Results: A total of 490 patients (49% female) with a median age of 73 years (interquartile range [IQR] 61–82) were included. No differences regarding age, sex and most underlying diseases were present at admission. Frequencies of the most common complications differed: acute kidney failure (ID 12.7%, Rheu 21.2%, Pulm 37.1%, p < 0.001), acute heart failure (ID 4.3%, Rheu 17.1%, Pulm 14.4%, p < 0.001) and respiratory insufficiency (ID 45.1%, Rheu 41.5%, Pulm 56.3%, p = 0.030). Oseltamivir prescription was lowest at the pulmonology flu ward (ID 79.6%, Rheu 90.5%, Pulm 61.7%, p < 0.001). In total 176 patients (35.9%) developed pneumonia. Antibiotic selection varied between the departments: amoxicillin/clavulanic acid (ID 28.9%, Rheu 63.8%, Pulm 5.9%, p < 0.001), cefuroxime (ID 28.9%, Rheu 1.3%, Pulm 0%, p < 0.001), 3rd generation cephalosporins (ID 4.4%, Rheu 5%, Pulm 72.5%, p < 0.001), doxycycline (ID 17.8%, Rheu 0%, Pulm 0%, p < 0.001). The median length of stay was significantly different between wards: ID 6 days (IQR 5–8), Rheu 6 days (IQR 5–7) and Pulm 7 days (IQR 5–9.5, p = 0.034). In-hospital mortality was 4.3% and did not differ between specialties. Conclusion: We detected differences in oseltamivir usage, length of in-hospital stay and antibiotic choices for pneumonia. Influenza-associated mortality was unaffected by specialty.
- Subjects
VIENNA (Austria); INFLUENZA; MEDICAL specialties &; specialists; HOSPITAL patients; ANTIBIOTICS; ACUTE kidney failure; RESPIRATORY insufficiency
- Publication
Wiener Klinische Wochenschrift, 2021, Vol 133, Issue 23/24, p1310
- ISSN
0043-5325
- Publication type
Article
- DOI
10.1007/s00508-021-01950-8