tetano
Editor, Senior Moderator
DENVER -- October 6, 2010 -- One-third of patients admitted with a suspected or confirmed infection with influenza A virus subtype H1N1 are admitted for undefined reason and may not require hospitalisation, researchers reported here at the American Academy of Family Physicians (AAFP) 2010 Scientific Assembly.
"Any time you admit someone to the hospital, there are risks of other infections, and there is also a cost issue," stated lead investigator Brayden McBride, MD, Utah Valley Regional Medical Center, Provo, Utah, on October 2. "In a world where medical costs are skyrocketing, hospital admissions may be a place where you can cut back unwarranted costs."
Dr. McBride's research team sought to analyse the causes and reasons for hospitalisation of non-intensive-care unit (ICU) patients infected with H1N1, to determine whether they were admitted to the hospital due to a higher acuity of illness or because of other factors, including comorbidities. To this end, they analysed data on hospitalised, H1N1-infected patients in adult non-ICU beds at the Urban South Region facilities of Intermountain Healthcare, Provo, Utah. The data were analysed in terms of demographic data, comorbidities, reasons for hospitalisation, laboratory and radiologic data, duration of hospitalisation, need for transfer to a higher level of care, and secondary complications.
Fifty-one patients (35 females) were admitted who did not require a higher level of care. The average age of these patients was 35.8 years. In all, 29.4% were pregnant, and 56.9% had medical comorbidities, including 15.7% with psychiatric disorders. Twenty-three of 35 people were given chest x-rays upon presentation, and although 34.29% had normal chest x-rays (normal oxygen saturation, minimal symptoms) all were admitted to the hospital in addition to receiving therapy for their illness, said Dr. McBride. There were 3 ICU transfers and 1 death.
"Based on our data ? [that] a third of patients with suspected or confirmed H1N1 infection are admitted for reasons other than pneumonia, these reasons need to be defined during further waves of an H1N1 infection," Dr. McBride stated. "In addition to considering patient age, cardiorespiratory status, laboratory abnormalities and comorbidities, presence or absence of chest radiograph abnormalities needs to be factored in with the decision regarding need for admission."
The team added that there was an interesting prevalence of psychiatric comorbidities in particular in their study. "We saw a couple of things that had been shown in other studies," said Dr. McBride, including that chronic lung diseases, depression, kidney problems, and cardiovascular problems tended to put people infected with H1N1 at higher risk. "But something we also noted, that was not noted in other studies, [was] that that we had almost as many patients with psychiatric comorbidities (15.7%) as we did with asthma (17.6%) or chronic obstructive pulmonary disease (9.8%). This may be a subset of our population that needs to be looked at a bit closer or watched a little bit more."
http://www.docguide.com/news/content.nsf/news/852576140048867C852577B40059038A
"Any time you admit someone to the hospital, there are risks of other infections, and there is also a cost issue," stated lead investigator Brayden McBride, MD, Utah Valley Regional Medical Center, Provo, Utah, on October 2. "In a world where medical costs are skyrocketing, hospital admissions may be a place where you can cut back unwarranted costs."
Dr. McBride's research team sought to analyse the causes and reasons for hospitalisation of non-intensive-care unit (ICU) patients infected with H1N1, to determine whether they were admitted to the hospital due to a higher acuity of illness or because of other factors, including comorbidities. To this end, they analysed data on hospitalised, H1N1-infected patients in adult non-ICU beds at the Urban South Region facilities of Intermountain Healthcare, Provo, Utah. The data were analysed in terms of demographic data, comorbidities, reasons for hospitalisation, laboratory and radiologic data, duration of hospitalisation, need for transfer to a higher level of care, and secondary complications.
Fifty-one patients (35 females) were admitted who did not require a higher level of care. The average age of these patients was 35.8 years. In all, 29.4% were pregnant, and 56.9% had medical comorbidities, including 15.7% with psychiatric disorders. Twenty-three of 35 people were given chest x-rays upon presentation, and although 34.29% had normal chest x-rays (normal oxygen saturation, minimal symptoms) all were admitted to the hospital in addition to receiving therapy for their illness, said Dr. McBride. There were 3 ICU transfers and 1 death.
"Based on our data ? [that] a third of patients with suspected or confirmed H1N1 infection are admitted for reasons other than pneumonia, these reasons need to be defined during further waves of an H1N1 infection," Dr. McBride stated. "In addition to considering patient age, cardiorespiratory status, laboratory abnormalities and comorbidities, presence or absence of chest radiograph abnormalities needs to be factored in with the decision regarding need for admission."
The team added that there was an interesting prevalence of psychiatric comorbidities in particular in their study. "We saw a couple of things that had been shown in other studies," said Dr. McBride, including that chronic lung diseases, depression, kidney problems, and cardiovascular problems tended to put people infected with H1N1 at higher risk. "But something we also noted, that was not noted in other studies, [was] that that we had almost as many patients with psychiatric comorbidities (15.7%) as we did with asthma (17.6%) or chronic obstructive pulmonary disease (9.8%). This may be a subset of our population that needs to be looked at a bit closer or watched a little bit more."
http://www.docguide.com/news/content.nsf/news/852576140048867C852577B40059038A