Introduction
Influenza poses a heavy burden on emergency departments (ED) and hospital wards. Fast
and reliable bedside tests are invaluable in obtaining indications for (cohort) droplet
isolation precautions and improving patient flow. We performed a cost-benefit analysis
comparing influenza point-of-care testing (POCT) to laboratory-based multiplex ligation-dependent
probe amplification.
Methods
Data of 275 ED presentations between January-April 2019 were analyzed. Patients received
both POCT and MLPA to calculate POCT sensitivity and specificity. Costs were calculated
for both a POCT and MLPA scenario, including costs for testing, admission, droplet
isolation precautions and cleaning.
Results
In our study population, 34 patients (12%) were identified with influenza A. No cases
of influenza B were identified. Mean age of the influenza positive patients was 75(18)
years and 56% were male. The most common symptoms upon presentation were cough, malaise
and fever, with 74%, 56% and 50%, respectively. Compared to MLPA, POCT yielded a sensitivity
of 94%, a specificity of 98% and a negative predictive value of 99% for influenza
A. Using POCT yielded a cost reduction of €93,26 per patient.
Conclusions
Influenza POCT is an accurate and cost-beneficial method to differentiate between
admission with or without droplet isolation precautions. It can be useful in clinical
decision making and reducing pressure on ED and hospital beds in an influenza peak
season, by enabling fast patient flow and cohort isolation.
Key Words
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Article Info
Publication History
Published online: May 10, 2021
Footnotes
Conflict of interest: All authors declare there are no financial relationships with any organizations that might have an interest in the submitted work and no other relationships or activities that could appear to have influenced the submitted work. None of the authors have any conflict of interest.
Identification
Copyright
© 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
