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Derivation and external validation of a simple prediction rule for the development of respiratory failure in hospitalized patients with influenza.


ABSTRACT:

Background

Influenza viruses cause seasonal epidemics worldwide with a significant morbimortality burden. Clinical spectrum of Influenza is wide, being respiratory failure (RF) one of its most severe complications. This study aims to elaborate a clinical prediction rule of RF in hospitalized Influenza patients.

Methods

A prospective cohort study was conducted during two consecutive Influenza seasons (December 2016-March 2017 and December 2017-April 2018) including hospitalized adults with confirmed A or B Influenza infection. A prediction rule was derived using logistic regression and recursive partitioning, followed by internal cross-validation. External validation was performed on a retrospective cohort in a different hospital between December 2018 and May 2019.

Results

Overall, 707 patients were included in the derivation cohort and 285 in the validation cohort. RF rate was 6.8% and 11.6%, respectively. Chronic obstructive pulmonary disease, immunosuppression, radiological abnormalities, respiratory rate, lymphopenia, lactate dehydrogenase and C-reactive protein at admission were associated with RF. A four category-grouped seven point-score was derived including radiological abnormalities, lymphopenia, respiratory rate and lactate dehydrogenase. Final model area under the curve was 0.796 (0.714-0.877) in the derivation cohort and 0.773 (0.687-0.859) in the validation cohort (p < 0.001 in both cases). The predicted model showed an adequate fit with the observed results (Fisher's test p > 0.43).

Conclusion

we present a simple, discriminating, well-calibrated rule for an early prediction of the development of RF in hospitalized Influenza patients, with proper performance in an external validation cohort. This tool can be helpful in patient's stratification during seasonal Influenza epidemics.

SUBMITTER: Ayuso B 

PROVIDER: S-EPMC9684757 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature

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Derivation and external validation of a simple prediction rule for the development of respiratory failure in hospitalized patients with influenza.

Ayuso Blanca B   Lalueza Antonio A   Arrieta Estibaliz E   Romay Eva María EM   Marchán-López Álvaro Á   García-País María José MJ   Folgueira Dolores D   Gude María José MJ   Cueto Cecilia C   Serrano Antonio A   Lumbreras Carlos C  

Respiratory research 20221124 1


<h4>Background</h4>Influenza viruses cause seasonal epidemics worldwide with a significant morbimortality burden. Clinical spectrum of Influenza is wide, being respiratory failure (RF) one of its most severe complications. This study aims to elaborate a clinical prediction rule of RF in hospitalized Influenza patients.<h4>Methods</h4>A prospective cohort study was conducted during two consecutive Influenza seasons (December 2016-March 2017 and December 2017-April 2018) including hospitalized adu  ...[more]

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