Hospital al Home Unit, Hospital Clínico San Carlos, C/Prof. Martín Lagos, s/n 28040 Madrid, Spain.
Eur J Intern Med. 2013 Jul;24(5):430-2. doi: 10.1016/j.ejim.2013.03.016. Epub 2013 Apr 25.
Elderly patients with uncomplicated diverticulitis are usually hospitalized. The aim of this study is to compare the outcomes of elderly patients with uncomplicated diverticulitis who were treated at home versus traditional Hospitalization.
Prospective study from March 2011 to September 2012 including patients over 70 years with uncomplicated diverticulitis admitted to Hospital at Home Unit and to Conventional Hospitalization from the Emergency Department. Patients with β-lactam allergy or who required admission to Conventional Hospitalization for other pathology were excluded. All patients were given intravenous antibiotic. Patients transferred to Hospital at Home stayed 24h in the Observation Ward within the Emergency Department prior to discharge. Characteristics and outcomes of patients are analyzed.
34 patients were treated at home and 18 in hospital. Mean age was similar in both groups (77 vs 79). The oldest patient treated at home was 90 years old. 64% of patients treated in Hospital at Home had comorbidity vs 68% in Conventional Hospitalization. 11% of patients treated at home were diabetic. Thickening colonic wall was present in 100% of patients. 38% of patients treated at home had free fluid vs 42% treated in Hospital. All patients had a good clinical evolution. None of the patients treated at home was transferred to Hospital. Home treatment was associated with a cost reduction of 1368 euros per patient.
Treatment at home of elderly patients with uncomplicated diverticulitis is as safe and effective as treatment in Hospital, even if patient has comorbidity.
患有单纯性憩室炎的老年患者通常需要住院治疗。本研究旨在比较在家庭治疗和传统住院治疗的患有单纯性憩室炎的老年患者的结局。
这是一项从 2011 年 3 月至 2012 年 9 月进行的前瞻性研究，包括入住家庭住院病房和从急诊科转入传统住院病房的 70 岁以上患有单纯性憩室炎的患者。排除对β-内酰胺类抗生素过敏或因其他疾病需要转入传统住院治疗的患者。所有患者均接受静脉内抗生素治疗。转入家庭住院病房的患者在急诊科观察病房留观 24 小时后出院。分析患者的特征和结局。
34 例患者在家庭治疗，18 例在医院治疗。两组患者的平均年龄相似（77 岁 vs 79 岁）。在家庭治疗的患者中年龄最大的为 90 岁。家庭治疗组 64%的患者合并症，传统住院组为 68%。家庭治疗组 11%的患者患有糖尿病。100%的患者结肠壁增厚。家庭治疗组 38%的患者有游离液体，而传统住院组为 42%。所有患者的临床症状均得到良好的缓解。家庭治疗组无患者转院。家庭治疗可使每位患者的费用降低 1368 欧元。
即使患者合并症，家庭治疗患有单纯性憩室炎的老年患者也是安全有效的，与在医院治疗效果相当。
