Missed opportunities to use rapid influenza testing and severity assessment to avoid hospital admission: A cohort study from an East London District General Hospital

J Med Virol. 2021 Jun;93(6):3934-3938. doi: 10.1002/jmv.26376. Epub 2020 Aug 13.

Abstract

Annual outbreaks of seasonal influenza cause a substantial health burden. The aim of this study was to compare patient demographic/clinical data in two influenza patient groups presenting to hospital; those requiring O2 or critical care admission and those requiring less intensive treatment. The study was conducted from 1 December 2017 until 1 April 2019 at a district general hospital in East London. Patient demographic and clinical information was collected for all patients who had tested influenza positive by near-patient testing. χ2 test was used for categorical variables to see if there were significant differences for those admitted and the Wilcoxon rank-sum test to compare the length of inpatient stay. Of 127 patients, 56 (44.1%) required oxygen or critical care. There were significant increases in National Early Warning Score (NEWS) observations (P %3C .001), Charlson comorbidity index (P = .049), length of inpatient stay (P %3C .001), and a strong association with increasing age (P = .066) when the more intensive treatment group was compared with the less intensive treatment group. A total of 13 (18.3%) of 71 patients not requiring oxygen or critical care were not admitted to the hospital. Following rapid influenza testing, NEWS scores, comorbidities, and age should be incorporated into a decision tool in Accident and Emergency to aid hospital admission or discharge decisions.

Keywords: admission avoidance; decision tool; influenza; near-patient testing; severity assessment.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Hospitalization / statistics & numerical data*
  • Hospitals, General / statistics & numerical data*
  • Humans
  • Influenza, Human / diagnosis*
  • Influenza, Human / epidemiology
  • Intensive Care Units / statistics & numerical data
  • London
  • Male
  • Middle Aged
  • Patient Admission / standards
  • Risk Assessment
  • Severity of Illness Index*
  • Time Factors
  • Triage / standards
  • Young Adult