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Gutierrez S.G.,Barrio Labeaga s n | Quintana J.M.,Barrio Labeaga s n | Baricot M.,University of the Basque Country | Bilbao A.,Hospital Universitario Basurto Osakidetza | And 74 more authors.
Emergency Medicine Journal | Year: 2014

Purpose: To identify risk factors present at admission in adult patients hospitalised due to influenza virus infection during the 2009/10 and 2010/11 seasons - including whether infection was from pandemic or seasonal influenza A infections - that were associated with the likelihood of developing severe pneumonia with multilobar involvement and shock. Methods: Prospective cohort study. Patients hospitalised due to influenza virus infection were recruited. We collected information on sociodemographic characteristics, pre-existing medical conditions, vaccinations, toxic habits, previous medications, exposure to social environments, and EuroQoL-5D (EQ-5D). Severe pneumonia with multilobar involvement and/or shock (SPAS) was the primary outcome of interest. We constructed two multivariate logistic regression models to explain the likelihood of developing SPAS and to create a clinical prediction rule for developing SPAS that includes clinically relevant variables. Results: Laboratory-con firmed A(H1N1)pdm09, EQ-5D utility score 7 days before admission, more than one comorbidity, altered mental status, dyspnoea on arrival, days from onset of symptoms, and in fluenza season were associated with SPAS. In addition, not being vaccinated against seasonal influenza in the previous year, anaemia, altered mental status, fever and dyspnoea on arrival at hospital, difficulties in performing activities of daily living in the previous 7 days, and days from onset of symptoms to arrival at hospital were related to the likelihood of SPAS (area under the curve value of 0.75; Hosmer-Lemeshow p value of 0.84). Conclusions: These variables should be taken into account by physicians evaluating a patient affected by influenza as additional information to that provided by the usual risk scores. Source


Martin V.,University of Leon | Martin V.,CIBER ISCIII | Castilla J.,CIBER ISCIII | Castilla J.,Institute Salud Publica Of Navarra | And 112 more authors.
Archivos de Bronconeumologia | Year: 2016

Introduction: Obesity has emerged as a significant independent predictor of severity in pandemic influenza A (H1N1)pdm09. The aim of this study was to investigate the association between body mass index (BMI) and the risk of hospitalization due to influenza. Methods: Hospitalized patients (n = 755) with laboratory-confirmed influenza were individually matched by age, admission/visit date, and province with an outpatient (n = 783) with laboratory-confirmed influenza and an outpatient control (n = 950). We compared the BMI using conditional logistic regression adjusted for potential confounding factors (aOR). The population attributable fraction (PAF) was calculated. Results: A higher BMI was associated with an increased risk of hospitalization compared to both outpatient cases (aOR = 1.11; 95% CI: 1.07-1.16) and outpatient controls (aOR = 1.04; 95% CI: 1.01-1.07). Compared with normal weight, obesity type I, obesity type II and obesity type III was associated with a greater likelihood of hospitalization compared with outpatient cases (aOR = 1.85, 95% CI: 1.05-3.26; aOR = 5.24, 95% CI: 1.94-14.15 and aOR = 44.38, 95% CI: 4.47-440.5). Compared with normal weight, obesity type II and obesity type III was associated with a greater likelihood of hospitalization compared with outpatient controls (aOR = 4.37, 95% CI: 1.79-10.69 and aOR = 4.95, 95% CI: 1.45-16.87). In persons without influenza vaccination, all categories of BMI ≥ 30 kg/m2 were associated with a greater likelihood of hospitalization compared with normal weight in both outpatient cases and outpatient controls. The PAF of hospitalization by influenza due to BMI ranged from 21.9% to 8.5%; in the case of unvaccinated against influenza between 20.5% to 16.9%. Conclusion: A high BMI is associated with an increased risk of hospitalization due to influenza. High percentage of hospital admissions are attributable to their BMI, especially in non vaccinated. © 2015 SEPAR. Source

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