The Utility of Preliminary Patient Evaluation in a Febrile Respiratory Infectious Disease Unit outside the Emergency Department

Kang, Jun Sik; Jhun, Byung Woo; Yoon, Hee; Lim, Seong Mi; Ko, Eunsil; Park, Joo Hyun; Hwang, Sung Yeon; Lee, Se Uk; Lee, Tae Rim; Cha, Won Chul; Shin, Tae Gun; Sim, Min Seob; Jo, Ik Joon

We additionally evaluated risk factors for predicting contagious diseases at the screening level. Patients who were diagnosed with contagious diseases were more likely to have a transplant history, but, oddly, they were less likely to have fever or leukocytosis. These results imply that commonly used clinical parameters, such as fever or leukocytosis, may not be enough to accurately discriminate between contagious and non-infectious diseases. In our study, only 62 of 97 (64%) patients with a contagious disease had a fever and 89 (92%) had leukocytosis. Both of these proportions were significantly lower than those for the remaining patients with non-contagious diseases (P = 0.031 for fever, P = 0.008 for leukocytosis). However, a more general interpretation of these findings is limited in that our institution is one of the largest tertiary-referral centers in Korea, and our patients generally have relatively severe or complicated conditions. There have been very few studies conducted on pre-hospital triage. During the 2009 influenza pandemic, an influenza-like illness scoring system was used to triage 1,840 ED patients with acute respiratory illness treated at a Mexican hospital (17) . In a study conducted in Qatar, a surveillance system protocol reduced the number of patients who needed to be tested for MERS-CoV at an ED (18) . However, to date, no data on the utility of screening systems outside the ED of tertiary medical centers have been collected at the pre-hospitalization stage, especially https://doi.org/10.3346/jkms.2017.32. 9.1534 for all emergency center patients; thus, our study is unique and significant.