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Sunday, August 30, 2009
Grand Hall/Exhibit Hall
Background: To determine the impact of oseltamivir on clinical outcomes in patients with laboratory confirmed influenza infection using ontology-based tools
Methods: Clinical records of patients were indexed and parsed bySNOMED CT , a large scale general medical ontology, using the Multi-threaded Clinical Vocabulary Server (MCVS), a set of informatics tools that allow the mapping of free text into coded data that are both expressive and comparable. Expert System was then applied to match clinical criteria against parsed records.
Results: 17,243 Patients from the Mayo Clinic were tested for influenza in the period 2000 – 2006. Of these, 1,455 (7.29%) patients had laboratory confirmed influenza; 87% influenza A, 13% influenza B. These 1,455 patients generated 41,585 records that underwent natural language processing and indexing with SNOMED CT. 226 (15.5%) were prescribed oseltamivir; 111 were prescribed other anti-influenza medications (amantadine, rimantadine, zanamivir); and 1130 patients did not receive any antiviral medications. Hospitalization rates, length of hospital stay, mortality rates, and comorbidities were compared between the group of patients treated with oseltamivir and the group of patients who did not receive any anti-influenza medications.
Methods: Clinical records of patients were indexed and parsed by
Results: 17,243 Patients from the Mayo Clinic were tested for influenza in the period 2000 – 2006. Of these, 1,455 (7.29%) patients had laboratory confirmed influenza; 87% influenza A, 13% influenza B. These 1,455 patients generated 41,585 records that underwent natural language processing and indexing with SNOMED CT. 226 (15.5%) were prescribed oseltamivir; 111 were prescribed other anti-influenza medications (amantadine, rimantadine, zanamivir); and 1130 patients did not receive any antiviral medications. Hospitalization rates, length of hospital stay, mortality rates, and comorbidities were compared between the group of patients treated with oseltamivir and the group of patients who did not receive any anti-influenza medications.
No Treatment | Oseltamivir | p-value | |
Hospitalization rate | 398 (35.2%) | 42 (18.6%) | <0.0001 |
Length of Hospital day (mean) | 5.32759 | 6.1186 | =0.13 |
Mortality | 4 ( 1.77%) | 32 (2.83%) | =0.4974 |
Malignancy | 36.28% | 51.33% | <0.0001 |
Diabetes | 29.29% | 37.61% | =0.0133 |
Heart Disease | 54.42% | 65.49% | =0.0022 |
Pulmonary Disease | 41.59% | 53.10% | =0.0014 |
Conclusion: Oseltamivir was associated with a significant reduction in hospitalization rates. The length of hospital stay in patients with laboratory confirmed influenza infection may show a trend favoring those treated with Oseltamivir. Patients treated with oseltamivir were more likely to have serious comorbidities. There was no statistically significant difference in mortality rates between the two groups.