Summary

Effectiveness of a home hospitalization program for patients with urinary tract infection after discharge from an emergency department

Gallardo MS, Antón A, Pulido Herrero E, Larruscain MI, Guinea Suárez R, García Gutiérrez S, Sandoval Negral JC

Affiliation of the authors

Servicio de Urgencias, Hospital Galdakao-Usansolo, Bizkaia, Spain. Unidad de Investigacion, OSI Barrualde-Galdakao [Osakidetza] – Red de Investigación en Servicios de Salud en Enfermedades Crónicas [REDISSEC], Galdakao, Bizkaia, Spain. Hospitalización a Domicilio-OSI Barrualde-Galdakao, Bizkaia, Spain. Servicio de Urgencias, Hospital de Txagorritxu, Vitoria, Spain. Hospitalización a Domicilio, Hospital Alto Deba, Gipuzkoa, Spain.

DOI

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Quote

Gallardo MS, Antón A, Pulido Herrero E, Larruscain MI, Guinea Suárez R, García Gutiérrez S, et al. Effectiveness of a home hospitalization program for patients with urinary tract infection after discharge from an emergency department. Emergencias. 2017;29:313-9

Summary

Objective.

To compare outcomes of urinary tract infections (UTIs) in patients referred to a home hospitalization program or admitted to a conventional ward after initial management in the emergency department.

Methods.

Prospective, quasi-experimental study of patients with UTIs attended in 3 hospital emergency departments in the public health system of the Basque Country, Spain, between January 2012 and June 2013. Patients were

assigned to 2 groups according to site of treatment (home or hospital ward) after discharge from the emergency department. We collected sociodemographic data, history of kidney or urologic symptoms, concomitant diseases, risk for complicated UTI, presentation on admission to the emergency department, diagnostic findings, and prescribed

treatments. The main outcome was poor clinical course (local complications during hospital or home care, recurrence, or readmission related to UTI. Multivariate logistic modeling was used to analyze factors related to poor clinical course. Home hospitalization was the main independent variable of interest.

Results.

Patients referred to home hospitalization were more often women (70.6% vs 57.1% men, P=.04). Fewer cases of prior admission were recorded in the group treated at home (2.4% vs 9.5% of hospitalized patients, P=.03). Likewise, fewer home-hospitalization patients had risk factors for complicated UTI (58.7% vs 83.3% in the hospitalized group,

P<.001). The only significant difference in complications between the 2 groups was a lower rate of acute confusional state in patients assigned to home hospitalization (0.8% vs 8.3% in hospitalized patients, P=.007). The frequency of poor clinical course was similar in home-hospitalized and ward-admitted patients. Conclusion. The clinical course of UTI is similar whether patients are hospitalized after emergency department management or discharged to a home hospitalization program.

 

More articles by the authors

Antón A, Gallardo MS, García-Gutiérrez S, Guinea Suárez R, Larruscain MI, Pulido Herrero E, Sandoval Negral JC

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