Admissions in hospital at home directly from the emergency department: an effective and safe alternative

Abstract

Objective: To analyze the profile of patients with infectious pathology who enter hospital at home after collection in the emergency department, support and quality of care. Method: Retrospective observational study. Variables: characteristics of the patient, type of infection, treatment, hospitalization parameters and quality indicators. Results: Including 255 patients with mean age 71 years (48.63% male, 51.37% female) and average Charlson index 4.91. Most frequent diagnoses: urinary tract infection (25.10%) and respiratory infection (24.71%), without microbiological identification in 62.75%. Most frequent isolation: E. coli (21.32%), with bacteremia being documented in 10.20% and criteria of sepsis in 14.51%. All of them required parenteral antibiotic therapy with average 6.5 days, with carbapenems being the most used (34.31%). Average stay in emergency department 21 hours and in hospital at home 7 days. There were 9.41% of complications, obtaining a reentry rate of 2.75%. Conclusions: After a short stay in emergency department, it´s possible to manage infections with variable criteria of severity and high comorbidity, giving the necessary support from hospital at home, without increasing complications or readmissions.

Keywords

• hospitalización a domicilio
• urgencias
• infección
• resistencia antimicrobiana
• antibioterapia parenteral
• terapia de infusión ambulatoria