Journal article
Real-Time Surveillance of Influenza Morbidity: Tracking Intensive Care Unit Resource Utilization
Annals of the American Thoracic Society, Vol.14(12), pp.1810-1817
12/2017
DOI: 10.1513/AnnalsATS.201609-721OC
PMCID: PMC5711258
PMID: 28799774
Abstract
Rationale: Existing real-time surveillance of influenza morbidity, based primarily on time-trended U.S. hospitalization and death data, is inadequate. These surveillance methods do not accurately predict hospital resource requirements or sufficiently capture the public health impact of the current influenza season.
Objectives: To determine the feasibility and potential usefulness of tracking surrogate markers of influenza morbidity among patients hospitalized with influenza.
Methods: We performed a pilot study at three tertiary care referral hospitals and retrospectively collected and analyzed data on patients admitted with influenza during the 2013–2014 influenza season. We analyzed traditional influenza surveillance metrics, including weekly statistics on admissions and deaths, as well as weekly rates and trends of intensive care unit (ICU), mechanical ventilation, and extracorporeal membrane oxygenation (ECMO) utilization.
Results: In our three-hospital cohort, 431 patients were hospitalized with influenza and spent a total of 1,520 days in ICUs. Eighty-six (20%) of these patients required 1,080 days of mechanical ventilation, and 17 patients (4%) received 229 days of ECMO. Trends of ICU and mechanical ventilation use were similar but differed notably from trends of ECMO use, hospitalization, and death. In particular, at two hospitals, increases in utilization of ICU and mechanical ventilation among patients with influenza occurred several weeks after increases in hospitalization rates. Furthermore, ICU, mechanical ventilation, and ECMO utilization rates at the three-hospital network remained elevated for several weeks after the influenza-associated hospitalization rate declined.
Conclusions: Surrogate markers of influenza severity were feasible to collect and revealed trends of ICU resource utilization that differed notably from trends of hospitalization and death given by traditional influenza surveillance metrics. A national network of sentinel hospitals that prospectively collects, time-trends, and reports additional influenza morbidity data would be useful to hospital administrators, hospital epidemiologists, infection preventionists, and public health officials.
Details
- Title: Subtitle
- Real-Time Surveillance of Influenza Morbidity: Tracking Intensive Care Unit Resource Utilization
- Creators
- Arthur W Baker - Division of Infectious Diseases, Department of Medicine, Duke University Hospital, Durham, North Carolina, Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North CarolinaMichael B Edmond - Division of Infectious Diseases, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia; and, Division of Infectious Diseases, Department of Internal Medicine, University of Iowa, Iowa City, IowaLoreen A Herwaldt - Division of Infectious Diseases, Department of Internal Medicine, University of Iowa, Iowa City, IowaLuke F Chen - Division of Infectious Diseases, Department of Medicine, Duke University Hospital, Durham, North Carolina, Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North CarolinaSudha Srikantaswamy - Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North CarolinaDaniel J Sexton - Division of Infectious Diseases, Department of Medicine, Duke University Hospital, Durham, North Carolina, Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Resource Type
- Journal article
- Publication Details
- Annals of the American Thoracic Society, Vol.14(12), pp.1810-1817
- DOI
- 10.1513/AnnalsATS.201609-721OC
- PMID
- 28799774
- PMCID
- PMC5711258
- NLM abbreviation
- Ann Am Thorac Soc
- ISSN
- 2329-6933
- eISSN
- 2325-6621
- Publisher
- American Thoracic Society
- Language
- English
- Date published
- 12/2017
- Academic Unit
- Infectious Diseases; Epidemiology; Internal Medicine
- Record Identifier
- 9984094400602771
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