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Effect of fever on hospital presentation, diagnosis, and treatment in patients with H1N1/09 influenza.
MedLine Citation:
PMID:  23024066     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Fever is typically considered part of the influenza-like illness in hemagglutinin type 1 and neuraminidase type 1 (H1N1/09) influenza. We assessed the proportion of patients that did not have fever as part of their illness prior to hospital presentation. We assessed the role of fever on the delay in hospital presentation, diagnosis, and treatment of these patients. METHODS: We performed a retrospective analysis of all hospitalized adult patients with laboratory-confirmed pandemic H1N1/09 at a tertiary care center in the United States from June 1 to December 31, 2009. RESULTS: Fifty-six of 135 study patients (42%) had no fever; 31 (23%) required intensive care unit (ICU) admission, and 9 (7%) died. Those without fever had higher Charlson index (P = 0.01), significantly longer time to hospital presentation (median 4 vs 2 days, P < 0.001), longer time to treatment since the onset of illness (median 5 vs 2 days, P = 0.001), and were more frequently in an ICU (P = 0.01). After adjustment for age (<40 vs ≥40) and Charlson index (0, 1-2, ≥3), patients without fever had significantly increased likelihood of late hospital presentation (>2 days from the onset of illness) (P = 0.001) and also had increased likelihood of ICU stay (P = 0.05). CONCLUSIONS: Forty-two percent of patients with laboratory-confirmed H1N1/09 did not have fever as part of their illness prior to hospital presentation. Patients without fever had delayed presentation to the hospital and thus experienced delayed treatment. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine.
Authors:
Madhuri M Sopirala; Douglas M Haas; Naeem A Ali; Julie E Mangino; Xueliang Pan; Abigail Norris Turner
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-28
Journal Detail:
Title:  Journal of hospital medicine : an official publication of the Society of Hospital Medicine     Volume:  -     ISSN:  1553-5606     ISO Abbreviation:  J Hosp Med     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-10-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101271025     Medline TA:  J Hosp Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Society of Hospital Medicine.
Affiliation:
Division of Infectious Diseases, University of Cincinnati, Cincinnati, Ohio; Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio; Department of Infection Control and Antimicrobial Stewardship, University of Cincinnati, Cincinnati, Ohio. madhuri.sopirala@uchealth.com.
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