Shimoni Z, Niven M, Kama N, Dusseldorp N, Froom P
Internal Medicine B, Laniado Hospital, Natanyia, Israel.
Eur J Intern Med. 2008 Nov;19(7):494-8. doi: 10.1016/j.ejim.2007.04.028. Epub 2008 Mar 19.
In developing countries, it may be easier to use the reasons why patients come to the emergency room (ER) instead of sentinel practices to identify influenza epidemics.
We studied the reasons why adult patients present to the ER in order to attempt to predict increased hospital activity as a result of influenza. The daily frequency of presenting symptoms during the 30 days of maximal influenza activity was compared to the other days of the study period (335 days).
During the influenza period, more patients presented with fever, syncope or near syncope, cough, asthma attack, and paralysis than on the days outside of this period. On 50% of the days, eight or more patients presented with fever, an 8.36 (95% CI=4.6-15.19) higher frequency than during the rest of the year. During the subsequent year, days with excess presentations by patients with a principal complaint of fever predicted increased hospital activity due to influenza with no false-positive periods.
We conclude that an increase in the number of patients presenting to the ER complaining of fever can identify increased hospital influenza activity.
在发展中国家，利用患者前往急诊室（ER）的原因而非哨点监测来识别流感流行可能更容易。
我们研究了成年患者前往急诊室的原因，以试图预测流感导致的医院就诊量增加情况。将流感活动高峰期30天内出现症状的每日频率与研究期间的其他日子（335天）进行比较。
在流感期间，与该时期之外的日子相比，有更多患者出现发热、晕厥或接近晕厥、咳嗽、哮喘发作和麻痹症状。在50%的日子里，有8名或更多患者出现发热，其频率比一年中的其他时间高8.36（95%置信区间=4.6-15.19）。在随后的一年中，以发热为主诉的患者就诊量过多的日子可预测因流感导致的医院就诊量增加，且无假阳性期。
我们得出结论，前往急诊室主诉发热的患者数量增加可识别出医院流感活动的增加。
