Management of hospitalized influenza A patients during the season 2018/19
Comparison of three medical departments and the effect on outcome and antibiotic usage
- 06.10.2021
- original article
Erschienen in:
- Verfasst von
- Mag. Dr. Mario Karolyi
- Erich Pawelka
- Hasan Kelani
- Georg Christian Funk
- Boris Lindner
- Christoph Porpaczy
- Sabine Publig
- Sara Omid
- Tamara Seitz
- Marianna Traugott
- Michael Turner
- Alexander Zoufaly
- Christoph Wenisch
- Erschienen in
- Wiener klinische Wochenschrift | Ausgabe 23-24/2021
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.
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- Titel
-
Management of hospitalized influenza A patients during the season 2018/19
Comparison of three medical departments and the effect on outcome and antibiotic usage - Verfasst von
-
Mag. Dr. Mario Karolyi
Erich Pawelka
Hasan Kelani
Georg Christian Funk
Boris Lindner
Christoph Porpaczy
Sabine Publig
Sara Omid
Tamara Seitz
Marianna Traugott
Michael Turner
Alexander Zoufaly
Christoph Wenisch
- Publikationsdatum
- 06.10.2021
- Verlag
- Springer Vienna
- Erschienen in
-
Wiener klinische Wochenschrift / Ausgabe 23-24/2021
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671 - DOI
- https://doi.org/10.1007/s00508-021-01950-8
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