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Factors for return to emergency department and hospitalization in elderly urinary tract infection patients
- Title
- Factors for return to emergency department and hospitalization in elderly urinary tract infection patients
- Authors
- Myoung, Joo Yeon; Hong, Jun Young; Lee, Dong Hoon; Lee, Choung Ah; Park, Sang Hyun; Kim, Duk Ho; Kim, Eui Chung; Lim, Jee Yong; Han, Sangsoo; Choi, Yoon Hee
- Ewha Authors
- 최윤희
- SCOPUS Author ID
- 최윤희
- Issue Date
- 2021
- Journal Title
- AMERICAN JOURNAL OF EMERGENCY MEDICINE
- ISSN
- 0735-6757
1532-8171
- Citation
- AMERICAN JOURNAL OF EMERGENCY MEDICINE vol. 50, pp. 283 - 288
- Keywords
- Urinary tract infection; Elderly patients; Emergency department; Early return visit; Antibiotic resistance; Empirical antibiotic
- Publisher
- W B SAUNDERS CO-ELSEVIER INC
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background: Appropriate decision of emergency department (ED) disposition is essential for improving the outcome of elderly urinary tract infection (UTI) patients. However, studies on early return visit (ERV) to the ED in elderly UTI patients are limited. Therefore, we aimed to identify factors for ERV and hospitalization after return visit (HRV) in this population. Methods: Elderly patients discharged from the ED with International Classification of diseases 10th Revision codes of UTI were selected from the registry for evaluation of ED revisit in 6 urban teaching hospitals. Retrospective data were extracted from the electronic medical records and ERV and hospitalization to scheduled revisit (SRV) were compared. Result: Among a total of 419 patients found in the study period, 45 were ERV patients and 24 were HRV patients. Absence of UTI-specific symptoms (odds ratio [OR] 2.789; 95% confidence interval [CI] 1.368-5.687; P = 0.005), C-reactive protein (CRP) levels >30 mg/L (OR 2.436; 95% CI 1.017-3.9; P = 0.024), and body temperature >= 38 degrees C (OR 1.992; 95% a 1.017-3.9; P = 0.044) were independent risk factors for ERV, and absence of UTI-specific symptoms (OR 3.832; 95% CI 1.455-10.088; P = 0.007), CRP levels >30 mg/L (OR 3.224; 95% CI 1.235-8.419; P = 0.017), and systolic blood pressure 100 mmHg (OR 3.795;95% CI 1.156-12.462; P = 0.028) were independent risk factors for HRV. However, there was no significant difference in empirical antibiotic resistance in ERV and HRV patients, compared to SRV patients. Conclusion: The independent risk factors of ERV and HRV should be considered for ED disposition in elderly UTI patients; the resistance to empirical antibiotics was not found to affect ERV or HRV within 3 days. (C) 2021 Published by Elsevier Inc.
- DOI
- 10.1016/j.ajem.2021.08.015
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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