Predictors of pandemic XXXX in adults presenting to two urban emergency departments, Toronto, 2009.

@entity1 @entity565 @entity591 @entity281 @entity683 @entity2613 @entity10 @entity925 @entity221
OBJECTIVE: Identifying features that differentiate @entity1 with @entity281 from those with other conditions may assist clinical decision making during waves of pandemic @entity683 activity. METHODS: From April 27 to June 15, 2009, nasopharyngeal swabs were obtained from all adults presenting to two urban emergency departments (EDs) with illness including @entity221 . @entity281 was detected by reverse transcriptase-polymerase chain reaction. Chart review was performed to compare cases of H1N1 @entity683 (n = 117) to matched controls. RESULTS: The median age of cases was 35 years versus 50 years for controls (p < .001). In those with pre-existing conditions, @entity565 was present in 31% of cases versus 14% of controls (OR 2.6, 95% CI 1.3-5.4). Cough (OR 7.8, 95% CI 3.2-19), fever (OR 3.0, 95% CI 1.7-5.4), @entity10 (OR 2.0, 95% CI 1.2-3.2), and @entity925 (OR 1.9, 95% CI 1.2-3.1) were significantly more common in H1N1 cases. The median white blood cell count was 5.7   109/mL versus 10.9   109/mL (p < .001). The combination of fever and cough had an OR of 5.3. Fever, cough, low white blood cell (WBC) count, and @entity591 had the highest OR at 11. The absence of both fever and cough had a negative predictive value of 99%, but this occurred in only 8% of controls. CONCLUSION: In @entity1 presenting to the @entity2613 , the combination of fever, cough, @entity591 , and WBC count < 10   109/mL was suggestive of @entity281 . However, clinical features could not reliably distinguish @entity683 from other acute respiratory illnesses in adult @entity2613 @entity1 .
