Ioannides-Demos L L, Addicott R, Santamaria N M, Clayton L, McKenzie M, Fairley C K
Victorian Centre for Ambulatory Care Innovation, Alfred Hospital, Prahran, Victoria, Australia.
Intern Med J. 2001 Apr;31(3):142-5. doi: 10.1046/j.1445-5994.2001.00031.x.
To determine whether the apparently longer length of stay (LOS) reported for patients with cellulitis managed in Hospital in the Home (HITH) compared with those managed as inpatients was correct.
Data, including LOS, from the Victorian In-patient Minimum Database (VIMD) of all patients with cellulitis managed between July 1998 and June 1999 at a large metropolitan teaching hospital were analysed and compared with a retrospective medical record review of the same patients.
In the VIMD data, there were 266 episodes of cellulitis during the study period. However, the medical record review found that six episodes were not separate, but rather a continuation of treatment for the same episode of cellulitis, and that 18 were not episodes of cellulitis, but were pilonidal sinus infections. In the VIMD data set, the mean LOS for patients treated in HITH was generally longer than that for inpatients (7.2 days vs 5.1 days, respectively, P = 0.002). However, in the retrospective medical record review, the LOS for patients treated in HITH was similar to inpatients (7.3 days versus 7.0 days, respectively, P = 0.68).
In contrast to the VIMD data, the medical record review demonstrated that, overall, patients with cellulitis had a similar LOS irrespective of whether they were managed at home or in hospital. This study confirms that caution is required in interpreting the VIMD data, highlights the importance of carefully monitoring the introduction of new treatment modalities and indicates areas for further research.
确定与住院治疗的蜂窝织炎患者相比，居家医院（HITH）管理的蜂窝织炎患者报告的住院时间（LOS）明显更长这一情况是否正确。
分析了1998年7月至1999年6月期间在一家大型都市教学医院接受治疗的所有蜂窝织炎患者的维多利亚州住院患者最小数据库（VIMD）中的数据，包括住院时间，并与对这些相同患者的回顾性病历审查结果进行了比较。
在VIMD数据中，研究期间有266例蜂窝织炎发作。然而，病历审查发现，有6例并非独立发作，而是同一例蜂窝织炎治疗的延续，并且有18例并非蜂窝织炎发作，而是藏毛窦感染。在VIMD数据集中，HITH治疗的患者的平均住院时间通常比住院患者更长（分别为7.2天和5.1天，P = 0.002）。然而，在回顾性病历审查中，HITH治疗的患者的住院时间与住院患者相似（分别为7.3天和7.0天，P = 0.68）。
与VIMD数据相反，病历审查表明，总体而言，蜂窝织炎患者的住院时间相似，无论他们是在家中还是在医院接受治疗。本研究证实，在解释VIMD数据时需要谨慎，强调了仔细监测新治疗模式引入的重要性，并指出了进一步研究的领域。
