Who Comes to the Emergency Room with an Infection from a Long-term Care Hospital? A Retrospective Study Based on a Medical Record Review

Abstract

Purpose: Health careeassociated infections increase disease prevalence and mortality and are the main reason for the hospitalization of the elderly. However, the management of underlying infections in patients hospitalized in long-term care hospitals (LTCHs) is insufficient, and the transfer of these poorly managed patients to the emergency room (ER) of an acute care hospital can lead to rapid spread of infection. This study investigated the risk factors associated with an ER visit due to infections that developed in LTCHs. Methods: The electronic medical records of patients who were transferred to the ER of a university hospital in South Korea were used. Infection prevalence, causative infectious agent, and antibiotic sensitivity were assessed. The associations between patient characteristics and hospital-associated infections were examined using multiple logistic regression analyses. Results: Among the 483 patients transferred to the ER during the study period, the number of infection cases was 197, and 171 individuals (35.4%) had one or more infections, with pneumonia being the most common (52.8%), followed by urinary tract (21.3%) and bloodstream (17.8%) infections. Patients with bedsores, fever, an indwelling catheter, and a higher nursing need were more likely to be seen in the ER because of infectious disease from an LTCH. Conclusion: Both an intensive care system and surveillance support should be established to prevent infections, particularly in high-risk patients at LTCHs