Who comes to the emergency room with an infection from a long-term care hospital? A retrospective study based on a medical record review.

PURPOSE: Healthcare-associated infections increase disease prevalence and mortality and are the main reason for the hospitalization of the elderly. However, the management of underlying infections in patients hospitalized in long-term care hospitals (LTCHs) is insufficient, and the transfer of these poorly managed patients to the emergency room (ER) of an acute-care hospital can lead to rapid spread of infection. This study investigated the risk factors associated with an ER visit due to infections that developed in LTCHs.

METHODS: The electronic medical records of patients who were transferred to the ER of a university hospital in South Korea, were used. Infection prevalence, causative infectious agent, and antibiotic sensitivity were assessed. The associations between patient characteristics and hospital-associated infections were examined using multiple logistic regression analyses.

RESULTS: Among the 483 patients transferred to the ER during the study period, the number of infection cases was 197, and 171 individuals (35.4%) had one or more infections, with pneumonia being the most common (52.8%), followed by urinary tract (21.3%) and bloodstream (17.8%) infections. Patients with bedsores, fever, an indwelling catheter, and with a higher nursing need were more likely to be seen in the ER due to infectious disease from an LTCH.

CONCLUSIONS: Both an intensive care system and surveillance support should be established to prevent infections, particularly in high-risk patients at LTCHs.