¿Son las unidades de corta estancia un recurso adecuado para la hospitalización de los pacientes ancianos con infección?

Zusammenfassung

Objective To describe the clinical characteristics and outcomes of elderly patients (≥ 75 years) with suspected infection attending the emergency department (ED) and to compare patients admitted to a short-stay unit (SSU) with those admitted to a conventional hospital unit (CHU). Material and methods Prospective cohort study including, using opportunity sampling, patients ≥75 years treated for infection in the ED of 3 Spanish university hospitals (2013). Demographic variables, comorbidity, baseline performance status, presence of sepsis, infection type, destination on discharge, and mortality at 30 days were collected. Results During the study period, 330 patients ≥75 years (mean age 83.8±7.3) were evaluated for a suspected infection in the ED, and 306 (93%) were admitted to the hospital, 175 (53%) to the CHU and 87 (26%) to the SSU. Medical history included hypertension (74.5%), arrhythmia (30%), chronic obstructive pulmonary disease (28%), and diabetes mellitus (26%), and risk factors for multidrug resistance, such as antibiotic treatment in 3 months prior to admission (48%), and institutionalisation (26%). A classic sepsis syndrome was found to be the source of infection in 53%, and was respiratory in half of patients. When comparing patients admitted to SSU and CHU, statistically significant differences (p<.05) were found in the Charlson index (1.95 vs. 2.51), Glasgow coma scale (14.6 vs. 14.3), classic sepsis syndrome (67% vs. 53%), severe sepsis (2.3% vs. 18%), length of stay (4.2 vs. 10.4 days), and mortality within 30 days (3.4% vs. 18%), respectively. Conclusions SSU may be an adequate alternative to CHU for elderly patients requiring admission with suspected infection.