Hospital triage system for adult patients using an influenza-like illness scoring system during the 2009 pandemic--Mexico.
<h4>Background</h4>Pandemic influenza A (H1N1) virus emerged during 2009. To help clinicians triage adults with acute respiratory illness, a scoring system for influenza-like illness (ILI) was implemented at Hospital Civil de Guadalajara, Mexico.<h4>Methods</h4>A medical hist...
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2010
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oai:doaj.org-article:57f77c7f5ac34f9cb48e1c570f33ffca2021-12-02T20:21:38ZHospital triage system for adult patients using an influenza-like illness scoring system during the 2009 pandemic--Mexico.1932-620310.1371/journal.pone.0010658https://doaj.org/article/57f77c7f5ac34f9cb48e1c570f33ffca2010-05-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/20498718/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Pandemic influenza A (H1N1) virus emerged during 2009. To help clinicians triage adults with acute respiratory illness, a scoring system for influenza-like illness (ILI) was implemented at Hospital Civil de Guadalajara, Mexico.<h4>Methods</h4>A medical history, laboratory and radiology results were collected on emergency room (ER) patients with acute respiratory illness to calculate an ILI-score. Patients were evaluated for admission by their ILI-score and clinicians' assessment of risk for developing complications. Nasal and throat swabs were collected from intermediate and high-risk patients for influenza testing by RT-PCR. The disposition and ILI-score of those oseltamivir-treated versus untreated, clinical characteristics of 2009 pandemic influenza A (H1N1) patients versus test-negative patients were compared by Pearson's Chi(2), Fisher's Exact, and Wilcoxon rank-sum tests.<h4>Results</h4>Of 1840 ER patients, 230 were initially hospitalized (mean ILI-score = 15), and the rest were discharged, including 286 ambulatory patients given oseltamivir (median ILI-score = 11), and 1324 untreated (median ILI-score = 5). Fourteen (1%) untreated patients returned, and 3 were hospitalized on oseltamivir (median ILI-score = 19). Of 371 patients tested by RT-PCR, 104 (28%) had pandemic influenza and 42 (11%) had seasonal influenza A detected. Twenty (91%) of 22 imaged hospitalized pandemic influenza patients had bilateral infiltrates compared to 23 (38%) of 61 imaged hospital test-negative patients (p<0.001). One patient with confirmed pandemic influenza presented 6 days after symptom onset, required mechanical ventilation, and died.<h4>Conclusions</h4>The triaging system that used an ILI-score complimented clinicians' judgment of who needed oseltamivir and inpatient care and helped hospital staff manage a surge in demand for services.Eduardo Rodriguez-NoriegaEsteban Gonzalez-DiazRayo Morfin-OteroGerardo F Gomez-AbundisJaime Briseño-RamirezHector Raul Perez-GomezHugo Lopez-GatellCelia M Alpuche-ArandaErnesto RamírezIrma LópezMiguel IgualaIetza Bojórquez ChapelaEthel Palacios ZavalaMauricio HernándezTammy L StuartMargarita Elsa VillarinoMarc-Alain WiddowsonSteve WatermanTimothy UyekiEduardo Azziz-BaumgartnerHospital Civil de Guadalajara, Fray Antonio Alcalde Emerging Respiratory Infections Response TeamPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 5, Iss 5, p e10658 (2010) |
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Medicine R Science Q Eduardo Rodriguez-Noriega Esteban Gonzalez-Diaz Rayo Morfin-Otero Gerardo F Gomez-Abundis Jaime Briseño-Ramirez Hector Raul Perez-Gomez Hugo Lopez-Gatell Celia M Alpuche-Aranda Ernesto Ramírez Irma López Miguel Iguala Ietza Bojórquez Chapela Ethel Palacios Zavala Mauricio Hernández Tammy L Stuart Margarita Elsa Villarino Marc-Alain Widdowson Steve Waterman Timothy Uyeki Eduardo Azziz-Baumgartner Hospital Civil de Guadalajara, Fray Antonio Alcalde Emerging Respiratory Infections Response Team Hospital triage system for adult patients using an influenza-like illness scoring system during the 2009 pandemic--Mexico. |
| description |
<h4>Background</h4>Pandemic influenza A (H1N1) virus emerged during 2009. To help clinicians triage adults with acute respiratory illness, a scoring system for influenza-like illness (ILI) was implemented at Hospital Civil de Guadalajara, Mexico.<h4>Methods</h4>A medical history, laboratory and radiology results were collected on emergency room (ER) patients with acute respiratory illness to calculate an ILI-score. Patients were evaluated for admission by their ILI-score and clinicians' assessment of risk for developing complications. Nasal and throat swabs were collected from intermediate and high-risk patients for influenza testing by RT-PCR. The disposition and ILI-score of those oseltamivir-treated versus untreated, clinical characteristics of 2009 pandemic influenza A (H1N1) patients versus test-negative patients were compared by Pearson's Chi(2), Fisher's Exact, and Wilcoxon rank-sum tests.<h4>Results</h4>Of 1840 ER patients, 230 were initially hospitalized (mean ILI-score = 15), and the rest were discharged, including 286 ambulatory patients given oseltamivir (median ILI-score = 11), and 1324 untreated (median ILI-score = 5). Fourteen (1%) untreated patients returned, and 3 were hospitalized on oseltamivir (median ILI-score = 19). Of 371 patients tested by RT-PCR, 104 (28%) had pandemic influenza and 42 (11%) had seasonal influenza A detected. Twenty (91%) of 22 imaged hospitalized pandemic influenza patients had bilateral infiltrates compared to 23 (38%) of 61 imaged hospital test-negative patients (p<0.001). One patient with confirmed pandemic influenza presented 6 days after symptom onset, required mechanical ventilation, and died.<h4>Conclusions</h4>The triaging system that used an ILI-score complimented clinicians' judgment of who needed oseltamivir and inpatient care and helped hospital staff manage a surge in demand for services. |
| format |
article |
| author |
Eduardo Rodriguez-Noriega Esteban Gonzalez-Diaz Rayo Morfin-Otero Gerardo F Gomez-Abundis Jaime Briseño-Ramirez Hector Raul Perez-Gomez Hugo Lopez-Gatell Celia M Alpuche-Aranda Ernesto Ramírez Irma López Miguel Iguala Ietza Bojórquez Chapela Ethel Palacios Zavala Mauricio Hernández Tammy L Stuart Margarita Elsa Villarino Marc-Alain Widdowson Steve Waterman Timothy Uyeki Eduardo Azziz-Baumgartner Hospital Civil de Guadalajara, Fray Antonio Alcalde Emerging Respiratory Infections Response Team |
| author_facet |
Eduardo Rodriguez-Noriega Esteban Gonzalez-Diaz Rayo Morfin-Otero Gerardo F Gomez-Abundis Jaime Briseño-Ramirez Hector Raul Perez-Gomez Hugo Lopez-Gatell Celia M Alpuche-Aranda Ernesto Ramírez Irma López Miguel Iguala Ietza Bojórquez Chapela Ethel Palacios Zavala Mauricio Hernández Tammy L Stuart Margarita Elsa Villarino Marc-Alain Widdowson Steve Waterman Timothy Uyeki Eduardo Azziz-Baumgartner Hospital Civil de Guadalajara, Fray Antonio Alcalde Emerging Respiratory Infections Response Team |
| author_sort |
Eduardo Rodriguez-Noriega |
| title |
Hospital triage system for adult patients using an influenza-like illness scoring system during the 2009 pandemic--Mexico. |
| title_short |
Hospital triage system for adult patients using an influenza-like illness scoring system during the 2009 pandemic--Mexico. |
| title_full |
Hospital triage system for adult patients using an influenza-like illness scoring system during the 2009 pandemic--Mexico. |
| title_fullStr |
Hospital triage system for adult patients using an influenza-like illness scoring system during the 2009 pandemic--Mexico. |
| title_full_unstemmed |
Hospital triage system for adult patients using an influenza-like illness scoring system during the 2009 pandemic--Mexico. |
| title_sort |
hospital triage system for adult patients using an influenza-like illness scoring system during the 2009 pandemic--mexico. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2010 |
| url |
https://doaj.org/article/57f77c7f5ac34f9cb48e1c570f33ffca |
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