Dr Ruchir Chavada1, Dr Liam Clifford2, Dr Owen Weisback2
1NSW Health Pathology, Gosford, NSW, Australia
2Department of Medicine, Gosford and Wyong Hospitals, Gosford,NSW, Australia
Introduction: Introduction of the rapid Influenza tests(RIT) has greatly assisted with diagnosis and aided the clinicians to not prescribe or stop antibiotics. There is limited data on its impact on patient management. We designed this study to identify patient factors affecting hospital discharge and to understand the role of RIT during the 2017 season.
Method: This was a retrospective observational study of all patients (children included) with seasonal influenza. Clinical data was captured from electronic medical records. RIT was performed using Xpert Flu/RSV (Cepheid, US). Categorical variables were assessed using Fischer’s exact tests and continuous variables using t test. SPSS Version 23(IBM, California) was used to perform multivariable analysis.
Results: 665 patients presented with laboratory confirmed Influenza. Discharged patients were slightly younger than those who got admitted (median age 62 vs 68, p=0.031). Patients with immunosuppression, chronic obstructive pulmonary disease(COPD) and pneumonia were more likely to be admitted (than discharged). Quicker turnaround time(TAT) of RIT was associated with higher rate of hospital discharge (vs. admission)- TAT ≤ 2 hours (27.8% vs 17.8 %, p=0.002) and TAT ≤ 6 hours (55% vs. 46.3%, p=0.026). On multivariable analysis, TAT of ≤2 hours (OR 1.6, p=0.016) was associated with higher discharge, whereas immunosuppressed patients (OR 2.17, p=0.016), COPD (OR 2.38, p=0.001) and pneumonia patients (OR 8.14, p=0.001) were more likely to get admitted.
Conclusion: Patients with COPD, pneumonia and immunosuppression are more likely to be admitted. RIT performed as soon as possible (TAT of ≤2 hours) can facilitate discharge of patients from hospital.
Dr R Chavada is a Clinical microbiologist and Infectious Diseases Physician on Central coast(CC) of NSW(Gosford/Wyong Hospitals). He was trained as a dual specialist in Sydney and upon completion of training joined the hospitals on the CC. His research interests are epidemiology of multi drug resistant organisms, medical tourism, hospital acquired infections and their surveillance and quality improvement in antimicrobial stewardship initiatives. He has published papers in above fields in peer reviewed journals. He maintains on active interest in hospital infection control activities and has introduced extended screening for MRO in ICUs on the CC and also worked towards local policies towards clearance of MROs in patients. He chairs the AMS steering Committee on the CC and also has active participation in improvement of AMS services on the CC.