Mario Karolyi1, Erich Pawelka2, Hasan Kelani2, Georg Christian Funk3, Boris Lindner4, Christoph Porpaczy4, Sabine Publig3, Sara Omid2, Tamara Seitz2, Marianna Traugott2, Michael Turner5, Alexander Zoufaly2, Christoph Wenisch2. 1. Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Kundratstr. 3, 1100, Vienna, Austria. mario.karolyi@gesundheitsverbund.at. 2. Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Kundratstr. 3, 1100, Vienna, Austria. 3. Medical Department II and Karl-Landsteiner Institute for Lung Research and Pulmonary Oncology, Klinik Ottakring, Vienna, Austria. 4. Medical Department II-Center for diagnosis and treatment of rheumatic diseases, Klinik Hietzing, Vienna, Austria. 5. Department for Rheumatology and Osteology, Klinik Favoriten, Vienna, Austria.
Abstract
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.
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.
Authors: E Pawelka; Mario Karolyi; S Daller; C Kaczmarek; H Laferl; I Niculescu; B Schrader; C Stütz; A Zoufaly; C Wenisch Journal: Infection Date: 2019-06-15 Impact factor: 3.553
Authors: Rachel McKay; Allison Mah; Michael R Law; Kimberlyn McGrail; David M Patrick Journal: Antimicrob Agents Chemother Date: 2016-06-20 Impact factor: 5.191
Authors: Mario Karolyi; Erich Pawelka; Simon Daller; Caroline Kaczmarek; Hermann Laferl; Iulia Niculescu; Birte Schrader; Christian Stütz; Alexander Zoufaly; Christoph Wenisch Journal: Wien Klin Wochenschr Date: 2019-06-18 Impact factor: 1.704
Authors: C Souty; S Masse; M Valette; S Behillil; I Bonmarin; C Pino; C Turbelin; L Capai; A M Vilcu; B Lina; S van der Werf; T Blanchon; A Falchi; T Hanslik Journal: Clin Microbiol Infect Date: 2019-01-29 Impact factor: 8.067