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Should clinical case definitions of influenza in hospitalized older adults include fever?

Falsey AR, Baran A, Walsh EE - Influenza Other Respir Viruses (2015)

Bottom Line: The highest temperature reported prior to admission or measured during the first 24 h after admission was recorded.The commonly used definition of ILI (fever ≥ 37·8°C and cough) resulted in 57% sensitivity and 71% specificity in older adults.Receiver operating characteristic curves examining the various temperature thresholds combined with cough and/or sore throat showed the optimal balance between sensitivity and specificity to be 37·9°C (AUC 0·71) and 37·3°C (AUC 0·66), in younger and older persons, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, University of Rochester, Rochester, NY, USA.

No MeSH data available.


Related in: MedlinePlus

Study flow chart of subjects in studies 1 and 2.
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fig01: Study flow chart of subjects in studies 1 and 2.

Mentions: A total of 2410 subjects were enrolled: 1568 in study 1 and 842 in study 2 (Figure1 and Table1). Approximately two-thirds (66·4%) of the subjects were over 65 years of age with an age range of 21–96 years. There was a high rate of chronic medical conditions among subjects, including congestive heart failure (30%), chronic obstructive pulmonary disease (52%), and diabetes mellitus (31%). Two hundred and eighty-one patients were diagnosed with influenza (261 with influenza A, 19 with influenza B, and one with mixed influenza A and B). Of the documented influenza infections, 123 (44%) were culture positive, 179 (64%) were RT-PCR positive, and 177 (63%) were seropositive, with most subjects having more than one test positive. During the seven seasons of surveillance, influenza H3N2 dominated in two seasons, H1N1 dominated in four seasons, and one season was mixed. The mean highest temperature was significantly higher in H3N2-dominant seasons compared with H1N1-dominant seasons (38·2°C ± 1·1 versus 37·8°C ± 1·1, P = 0·008).


Should clinical case definitions of influenza in hospitalized older adults include fever?

Falsey AR, Baran A, Walsh EE - Influenza Other Respir Viruses (2015)

Study flow chart of subjects in studies 1 and 2.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4549099&req=5

fig01: Study flow chart of subjects in studies 1 and 2.
Mentions: A total of 2410 subjects were enrolled: 1568 in study 1 and 842 in study 2 (Figure1 and Table1). Approximately two-thirds (66·4%) of the subjects were over 65 years of age with an age range of 21–96 years. There was a high rate of chronic medical conditions among subjects, including congestive heart failure (30%), chronic obstructive pulmonary disease (52%), and diabetes mellitus (31%). Two hundred and eighty-one patients were diagnosed with influenza (261 with influenza A, 19 with influenza B, and one with mixed influenza A and B). Of the documented influenza infections, 123 (44%) were culture positive, 179 (64%) were RT-PCR positive, and 177 (63%) were seropositive, with most subjects having more than one test positive. During the seven seasons of surveillance, influenza H3N2 dominated in two seasons, H1N1 dominated in four seasons, and one season was mixed. The mean highest temperature was significantly higher in H3N2-dominant seasons compared with H1N1-dominant seasons (38·2°C ± 1·1 versus 37·8°C ± 1·1, P = 0·008).

Bottom Line: The highest temperature reported prior to admission or measured during the first 24 h after admission was recorded.The commonly used definition of ILI (fever ≥ 37·8°C and cough) resulted in 57% sensitivity and 71% specificity in older adults.Receiver operating characteristic curves examining the various temperature thresholds combined with cough and/or sore throat showed the optimal balance between sensitivity and specificity to be 37·9°C (AUC 0·71) and 37·3°C (AUC 0·66), in younger and older persons, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, University of Rochester, Rochester, NY, USA.

No MeSH data available.


Related in: MedlinePlus