Hospitalization of 780 episodes of infection in 10 Spanish emergency departments. Admission to conventional wards or short stay units?

Abstract

Background. To study the clinical characteristics of patients with infection attending the emergency department (ED) and compare those admitted to a short stay unit (SSU) with those admitted to a conventional hospital ward (CHW).

Methods. A descriptive multicenter cross-sectional analy­sis of infected patients requiring admission from 10 ED with SSU. Data were collected for age, gender, comorbidities, risk factors for multiresistant pathogens, type of infection, sepsis criteria, microbiology and antibiotic treatment.

Results. We documented 780 admitted patients, mean age 70.43 years, 31% with heart disease, 29% COPD, 26% diabetes mellitus, 15% prior antibiotic therapy and solid neoplasm. Fifty-four percent were respiratory infections, 22% urinary infections and 8% intra-abdominal infections. Thirteen percent had septic syndrome and beta-lactam (64%) and fluoroquinolones (29%) were the most prescribed antibiotics. When comparing patients admitted to SSU (183) with those admitted to CHW (597), in the latter group there were more comorbidities (86% vs. 78%), more risk factors for multidrug-resistant pathogens (42% vs. 25%) and cultures from different sources were more frequently undertaken (80% vs. 64%) (p <0.05).

Conclusions. According to our results, SSU may be an excellent alternative to CHW for patients with prevalent infection and less comorbidity and fewer risk factors for multidrug resistance.