Using age, triage score, and disposition data from emergency department electronic records to improve Influenza-like illness surveillance

Objective Markers of illness severity are increasingly captured in emergency department (ED) electronic systems, but their value for surveillance is not known. We assessed the value of age, triage score, and disposition data from ED electronic records for predicting influenza-related hospitalizations.Materials and Methods From June 2006 to January 2011, weekly counts of pneumonia and influenza (P&I) hospitalizations from five Montreal hospitals were modeled using negative binomial regression. Over lead times of 0–5 weeks, we assessed the predictive ability of weekly counts of 1) total ED visits, 2) ED visits with influenza-like illness (ILI), and 3) ED visits with ILI stratified by age, triage score, or disposition. Models were adjusted for secular trends, seasonality, and autocorrelation. Model fit was assessed using Akaike information criterion, and predictive accuracy using the mean absolute scaled error (MASE).Results Predictive accuracy for P&I hospitalizations during non-pandemic years was improved when models included visits from patients ≥65 years old and visits resulting in admission/transfer/death (MASE of 0.64, 95% confidence interval (95% CI) 0.54–0.80) compared to overall ILI visits (0.89, 95% CI 0.69–1.10). During the H1N1 pandemic year, including visits from patients
Source: Journal of the American Medical Informatics Association - Category: Information Technology Authors: Tags: Research and Applications Source Type: research

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ConclusionHCF significantly alleviated H1N1-induced ALI in mice, which were associated with its dual antiviral and anti-inflammatory effects via inhibiting influenzal NA activity and TLR signalling. Among the four major flavonoid glycosides in HCF, hyperin and quercitrin played key roles in the therapeutic effect of HCF.Graphical abstract
Source: Phytomedicine - Category: Drugs & Pharmacology Source Type: research
Conclusions: The influenza vaccination uptake was 11% among HCWs in India. The barrier to vaccination is the belief that they were healthy not to contract it. Measures need to be taken to improve the vaccination rate among HCWs in India.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Respiratory infections Source Type: research
AbstractNo studies evaluating the association between statins and outcomes of patients with seasonal influenza have been performed since the 2007 –2008 and the 2009 pandemic H1N1 influenza seasons. All consecutive hospitalized patients between October 2017 and April 2018, diagnosed with laboratory-confirmed influenza A and B virus, were included. Patients were divided into two groups: statin and non-statin users. Outcomes were 30- and 90-da y mortality, complications (pneumonia, myocarditis, encephalitis, intensive care unit (ICU) transfer, mechanical ventilation, vasopressor support), length of hospital stay, and re...
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research
In this study, we aim to analyze the current evidence and findings associated with influenza and other emergent viral infections, namely, herpes simplex virus type 1 (HSV-1), Epstein-Barr virus (EBV), and cytomegalovirus (CMV).Among medical conditions, community-acquired respiratory infections are the most frequent reason for ventilatory support in ICUs. Community-acquired pneumonia in a severe form including the need of invasive mechanical ventilation and/or vasopressors is associated with high mortality rates. However, after the pandemic that occurred in 2009 by H1N1 influenza, the number of cases being admitted to ICUs ...
Source: Seminars in Respiratory and Critical Care Medicine - Category: Respiratory Medicine Authors: Tags: Review Article Source Type: research
Purpose of review Overview of influenza infection, focusing on outcome and complications in critically ill patients. We also discuss relevant elements in immunopathogenesis and their role as predictors of severity. Recent findings Pandemic influenza A (H1N1) virus circulates seasonally and remains the predominant subtype among intensive care patients. Mortality in acute respiratory failure (ARF) is around 20%, independent of influenza subtypes. During severe infection, the imbalance between pro-inflammatory and anti-inflammatory molecules, such as Th1 and Th17 cytokines, is associated with complicated infections and m...
Source: Current Opinion in Critical Care - Category: Nursing Tags: SEVERE INFECTIONS: Edited by Michael S. Niederman Source Type: research
Conclusions: The clinical features and outcomes of pandemic (H1N1) 2009 influenza and current circulating seasonal influenza A strains were comparable in hospitalised patients. However, since both seasonal and pandemic influenza can lead to significant morbidity and mortality, the impact of pre-existing seasonal influenza should not be underestimated during the pandemic period. PMID: 31304711 [PubMed - in process]
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
Poshmaal Dhar1 and Julie McAuley2* 1Faculty of Health, School of Medicine, Deakin University, Geelong, VIC, Australia 2Department of Microbiology and Immunology, Peter Doherty Institute, University of Melbourne, Melbourne, VIC, Australia The family of cell surface (cs-) mucins are constitutively expressed at the cell surface by nearly all epithelial cells, beneath the gel-mucin layer. All cs-mucin family members have structural features that enable them to act as a releasable decoy barrier to mucosal pathogens, by providing ligands for pathogen binding and the ability to shed the bound extracellular domain. Due ...
Source: Frontiers in cellular and infection microbiology - Category: Microbiology Source Type: research
Conclusions: Human challenge studies and systems biology approaches are important tools that should be used in concert to advance our understanding of influenza infection and provide targets for novel therapeutics and immunizations. Introduction Although influenza virus was recognized as an important pathogen over a century ago, influenza continues to cause a significant burden of disease. In the United States alone, it's estimated that in the 2017–2018 season there were 959,000 hospitalizations related to influenza illness, and 79,400 deaths (CDC, 2018). Worldwide, WHO estimates that annual influenza...
Source: Frontiers in cellular and infection microbiology - Category: Microbiology Source Type: research
Jennifer M. Rudd1, Sivasami Pulavendran1, Harshini K. Ashar1, Jerry W. Ritchey1, Timothy A. Snider1, Jerry R. Malayer1, Montelongo Marie1, Vincent T. K. Chow2 and Teluguakula Narasaraju1* 1Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, United States2Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore Exaggerated host innate immune responses have been implicated in severe influenza pneumonia. We have previously demonstrated that excessive neutrophils recruited during in...
Source: Frontiers in cellular and infection microbiology - Category: Microbiology Source Type: research
Abstract Cadmium (Cd) is a toxic, pro-inflammatory metal ubiquitous in the diet that accumulates in body organs due to inefficient elimination. Responses to influenza virus infection are variable, particularly severity of pneumonia. We used a murine model of chronic low-dose oral exposure to Cd to test if increased lung tissue Cd worsened inflammation in response to sub-lethal H1N1 infection. The results show that Cd-treated mice had increased lung tissue inflammatory cells, including neutrophils, monocytes, T lymphocytes and dendritic cells, following H1N1 infection. Lung genetic responses to infection (increasin...
Source: Environment International - Category: Environmental Health Authors: Tags: Environ Int Source Type: research
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