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Real-Time Surveillance of Influenza Morbidity: Tracking Intensive Care Unit Resource Utilization.

Publication ,  Journal Article
Baker, AW; Edmond, MB; Herwaldt, LA; Chen, LF; Srikantaswamy, S; Sexton, DJ
Published in: Ann Am Thorac Soc
December 2017

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.

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Published In

Ann Am Thorac Soc

DOI

EISSN

2325-6621

Publication Date

December 2017

Volume

14

Issue

12

Start / End Page

1810 / 1817

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Retrospective Studies
  • Respiration, Artificial
  • Pilot Projects
  • Morbidity
  • Middle Aged
  • Male
  • Intensive Care Units
  • Influenza, Human
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Baker, A. W., Edmond, M. B., Herwaldt, L. A., Chen, L. F., Srikantaswamy, S., & Sexton, D. J. (2017). Real-Time Surveillance of Influenza Morbidity: Tracking Intensive Care Unit Resource Utilization. Ann Am Thorac Soc, 14(12), 1810–1817. https://doi.org/10.1513/AnnalsATS.201609-721OC
Baker, Arthur W., Michael B. Edmond, Loreen A. Herwaldt, Luke F. Chen, Sudha Srikantaswamy, and Daniel J. Sexton. “Real-Time Surveillance of Influenza Morbidity: Tracking Intensive Care Unit Resource Utilization.Ann Am Thorac Soc 14, no. 12 (December 2017): 1810–17. https://doi.org/10.1513/AnnalsATS.201609-721OC.
Baker AW, Edmond MB, Herwaldt LA, Chen LF, Srikantaswamy S, Sexton DJ. Real-Time Surveillance of Influenza Morbidity: Tracking Intensive Care Unit Resource Utilization. Ann Am Thorac Soc. 2017 Dec;14(12):1810–7.
Baker, Arthur W., et al. “Real-Time Surveillance of Influenza Morbidity: Tracking Intensive Care Unit Resource Utilization.Ann Am Thorac Soc, vol. 14, no. 12, Dec. 2017, pp. 1810–17. Pubmed, doi:10.1513/AnnalsATS.201609-721OC.
Baker AW, Edmond MB, Herwaldt LA, Chen LF, Srikantaswamy S, Sexton DJ. Real-Time Surveillance of Influenza Morbidity: Tracking Intensive Care Unit Resource Utilization. Ann Am Thorac Soc. 2017 Dec;14(12):1810–1817.

Published In

Ann Am Thorac Soc

DOI

EISSN

2325-6621

Publication Date

December 2017

Volume

14

Issue

12

Start / End Page

1810 / 1817

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Retrospective Studies
  • Respiration, Artificial
  • Pilot Projects
  • Morbidity
  • Middle Aged
  • Male
  • Intensive Care Units
  • Influenza, Human