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Seasonal Burden of Severe Influenza Virus Infection in the Critically Ill Patients, Using the Assistance Publique-Hôpitaux de Paris Clinical Data Warehouse: A Pilot Study

Muriel Fartoukh 1 Guillaume Voiriot 1 Laurent Guérin 2 Jean Damien Ricard 3 Alain Combes 4, 5 Morgane Faure 6 Sarah Benghanem 7 Etienne De Montmollin 3 yacine Tandjaoui-Lambiotte 8 Antoine Vieillard-Baron 9 Eric Maury 10, 11 Jean-Luc Diehl 12 Keyvan Razazi 13 Virginie Lemiale 14 Pierre Trouiller 15 Benjamin Planquette 12 Laurent Savale 16 Nicholas Heming 17 Jonathan Marey 18 Fabrice Carrat 11, 19 Nathanael Lapidus 11, 19 
Abstract : Abstract Purpose At the critical care level, the flu surveillance system is limited in France, with heterogeneous regional modalities of implementation. Materials, patients and methods We aimed at assessing the relevance of the Assistance Publique-Hôpitaux de Paris (AP-HP) clinical data warehouse for estimating the burden of the influenza epidemic on medical adult critical care units of the AP-HP, and outcome of patients during the flu season 2017\textendash 2018. This exploratory multi-site epidemiological study comprised all consecutive adult stays ( n \,=\,320) in 18 medical intensive care units (ICU) or intermediate care wards (ICW) for probable or confirmed Influenza virus infection during the 2017\textendash 2018 flu season. Results Patients admitted to ICU/ICW had low vaccination coverage (21%), required life support in 60% of cases, stayed in the ICU for a median of 8~days, and had high 28-day mortality rate (19.7%; 95% confidence interval 15.5\textendash 24.5). Early prognostic factors included age, core temperature, the acute organ failures score, and the early administration of antiviral therapy. Conclusions Data directly extracted from the electronic medical records stored in the data warehouse provide detailed clinical, care pathway and prognosis information. The real-time availability should enable to detect and assess the burden of the most severe cases. By a firmer and more acute monitoring and adjustment of care and patient management, hospitals could generate more ICU/ICW capacities, sensitize their emergency department and contribute to the recommendations from health authorities. This pilot study is of particular relevance in the context of emerging epidemics of severe acute respiratory diseases.
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https://hal.sorbonne-universite.fr/hal-03702940
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Submitted on : Thursday, June 23, 2022 - 3:02:05 PM
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Muriel Fartoukh, Guillaume Voiriot, Laurent Guérin, Jean Damien Ricard, Alain Combes, et al.. Seasonal Burden of Severe Influenza Virus Infection in the Critically Ill Patients, Using the Assistance Publique-Hôpitaux de Paris Clinical Data Warehouse: A Pilot Study. Annals of intensive care, 2021, 11 (1), pp.117. ⟨10.1186/s13613-021-00884-8⟩. ⟨hal-03702940⟩

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