Influence of Referral Pathway on Ebola Virus Disease Case-Fatality Rate and Effect of Survival Selection Bias

Case-fatality rates in Ebola treatment centers (ETCs) varied widely during the Ebola virus disease (EVD) outbreak in West Africa. We assessed the influence of referral pathway on ETC case-fatality rates with a retrospective cohort of 126 patients treated at the Mathaska ETC in Port Loko, Sierra Leon...

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Autores principales: Rudolf, Frauke, Damkjær, Mads, Lunding, Suzanne, Dornonville de la Cour, Kenn, Young, Alyssa, Brooks, Tim, Sesay, Tom, Salam, Alex P., Mishra, Sharmistha, Storgaard, Merete
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Centers for Disease Control and Prevention 2017
Materias:
Research
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367409/
https://www.ncbi.nlm.nih.gov/pubmed/28322693
http://dx.doi.org/10.3201/eid2304.160485
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author Rudolf, Frauke
Damkjær, Mads
Lunding, Suzanne
Dornonville de la Cour, Kenn
Young, Alyssa
Brooks, Tim
Sesay, Tom
Salam, Alex P.
Mishra, Sharmistha
Storgaard, Merete
author_facet Rudolf, Frauke
Damkjær, Mads
Lunding, Suzanne
Dornonville de la Cour, Kenn
Young, Alyssa
Brooks, Tim
Sesay, Tom
Salam, Alex P.
Mishra, Sharmistha
Storgaard, Merete
author_sort Rudolf, Frauke
collection PubMed
description Case-fatality rates in Ebola treatment centers (ETCs) varied widely during the Ebola virus disease (EVD) outbreak in West Africa. We assessed the influence of referral pathway on ETC case-fatality rates with a retrospective cohort of 126 patients treated at the Mathaska ETC in Port Loko, Sierra Leone. The patients consisted of persons who had confirmed EVD when transferred to the ETC or who had been diagnosed onsite. The case-fatality rate for transferred patients was 46% versus 67% for patients diagnosed onsite (p = 0.02). The difference was mediated by Ebola viral load at diagnosis, suggesting a survival selection bias. Comparisons of case-fatality rates across ETCs and clinical management strategies should account for potential survival selection bias.
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spelling pubmed-53674092017-04-07 Influence of Referral Pathway on Ebola Virus Disease Case-Fatality Rate and Effect of Survival Selection Bias Rudolf, Frauke Damkjær, Mads Lunding, Suzanne Dornonville de la Cour, Kenn Young, Alyssa Brooks, Tim Sesay, Tom Salam, Alex P. Mishra, Sharmistha Storgaard, Merete Emerg Infect Dis Research Case-fatality rates in Ebola treatment centers (ETCs) varied widely during the Ebola virus disease (EVD) outbreak in West Africa. We assessed the influence of referral pathway on ETC case-fatality rates with a retrospective cohort of 126 patients treated at the Mathaska ETC in Port Loko, Sierra Leone. The patients consisted of persons who had confirmed EVD when transferred to the ETC or who had been diagnosed onsite. The case-fatality rate for transferred patients was 46% versus 67% for patients diagnosed onsite (p = 0.02). The difference was mediated by Ebola viral load at diagnosis, suggesting a survival selection bias. Comparisons of case-fatality rates across ETCs and clinical management strategies should account for potential survival selection bias. Centers for Disease Control and Prevention 2017-04 /pmc/articles/PMC5367409/ /pubmed/28322693 http://dx.doi.org/10.3201/eid2304.160485 Text en https://creativecommons.org/licenses/by/4.0/This is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.
spellingShingle Research
Rudolf, Frauke
Damkjær, Mads
Lunding, Suzanne
Dornonville de la Cour, Kenn
Young, Alyssa
Brooks, Tim
Sesay, Tom
Salam, Alex P.
Mishra, Sharmistha
Storgaard, Merete
Influence of Referral Pathway on Ebola Virus Disease Case-Fatality Rate and Effect of Survival Selection Bias
title Influence of Referral Pathway on Ebola Virus Disease Case-Fatality Rate and Effect of Survival Selection Bias
title_full Influence of Referral Pathway on Ebola Virus Disease Case-Fatality Rate and Effect of Survival Selection Bias
title_fullStr Influence of Referral Pathway on Ebola Virus Disease Case-Fatality Rate and Effect of Survival Selection Bias
title_full_unstemmed Influence of Referral Pathway on Ebola Virus Disease Case-Fatality Rate and Effect of Survival Selection Bias
title_short Influence of Referral Pathway on Ebola Virus Disease Case-Fatality Rate and Effect of Survival Selection Bias
title_sort influence of referral pathway on ebola virus disease case-fatality rate and effect of survival selection bias
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367409/
https://www.ncbi.nlm.nih.gov/pubmed/28322693
http://dx.doi.org/10.3201/eid2304.160485
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