From the Medical Device Research Institute, College of Science and Engineering, Flinders University, Adelaide, South Australia.
Infectious Diseases Department, Women's and Children's Hospital, North Adelaide, South Australia.
J Patient Saf. 2020 Jun;16(2):123-129. doi: 10.1097/PTS.0000000000000617.
The aim of the study was to evaluate clinical outcomes and adverse events (AEs) experienced by patients treated within the Hospital in the Home (HITH) service of a major metropolitan hospital in South Australia.
A retrospective case note audit of 100 HITH episodes among adults who received continuous intravenous antimicrobial therapy via an elastomeric or electronic infusion device was undertaken. Age- and sex-adjusted binomial logistic regression analyses were undertaken to identify factors associated with major and minor AEs.
Of the 100 patients included, 71 were male and the mean (SD) patient age was 62.8 (17.19) years. Elastomeric infusion devices were used for 98 patients. The mean (SD) HITH treatment duration was 20.1 (11.9) days. Overall, 130 AEs were documented for 72 patients (72%), of whom 12 patients experienced a major AE and 68 patients experienced a minor AE. There were 45 occasions among 23 patients where an infusion administered through an elastomeric device did not run to completion. Fifteen patients were readmitted to hospital. Minor AEs were more likely among people with more vascular line days (adjusted odds ratio [aOR] = 1.05; 95% confidence interval (CI) = 1.01-1.10 per day increase) and females (aOR = 4.43; 95% CI = 1.14-17.17). An increased number of vascular line days was associated with an increased likelihood of an incomplete infusion (aOR = 1.05; 95% CI = 1.01-1.09). Hospital readmission was more likely with increasing age (aOR = 1.06; 95% CI = 1.01-1.11 per year increase).
Adverse events need to be monitored carefully when HITH treatment is provided for extended periods.
本研究旨在评估南澳大利亚一家主要大都市医院的家庭住院（HITH）服务中接受连续静脉内抗菌治疗的患者的临床结局和不良事件（AE）。
对 100 例接受弹性或电子输注装置连续静脉内抗菌治疗的成人 HITH 发作进行回顾性病历审核。采用年龄和性别调整的二项逻辑回归分析，确定与主要和次要 AE 相关的因素。
在纳入的 100 例患者中，71 例为男性，平均（SD）患者年龄为 62.8（17.19）岁。98 例患者使用弹性输注装置。HITH 治疗平均（SD）持续时间为 20.1（11.9）天。总体而言，72 例患者（72%）记录了 130 例 AE，其中 12 例患者发生重大 AE，68 例患者发生轻微 AE。在 23 例患者中有 45 次弹性装置给药未完成。15 例患者再次入院。血管通路天数较多的患者（调整后的优势比[aOR]为 1.05；95%置信区间[CI]为每天增加 1.01-1.10）和女性（aOR = 4.43；95% CI = 1.14-17.17）更有可能发生轻微 AE。血管通路天数增加与不完全输注的可能性增加相关（aOR = 1.05；95% CI = 1.01-1.09）。随着年龄的增加，住院再次入院的可能性增加（aOR = 1.06；95% CI = 1.01-1.11，每年增加）。
当 HITH 治疗时间延长时，需要仔细监测不良事件。
