دورية أكاديمية
Safety of Outpatient Parenteral Antimicrobial Therapy in Nonagenarians.
| العنوان: | Safety of Outpatient Parenteral Antimicrobial Therapy in Nonagenarians. |
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| المؤلفون: | Shrestha NK; Department of Infectious Diseases, Cleveland Clinic, Cleveland, Ohio, USA., Blaskewicz C; Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA., Gordon SM; Department of Infectious Diseases, Cleveland Clinic, Cleveland, Ohio, USA., Everett A; Department of Infectious Diseases, Cleveland Clinic, Cleveland, Ohio, USA., Rehm SJ; Department of Infectious Diseases, Cleveland Clinic, Cleveland, Ohio, USA. |
| المصدر: | Open forum infectious diseases [Open Forum Infect Dis] 2020 Oct 03; Vol. 7 (10), pp. ofaa398. Date of Electronic Publication: 2020 Oct 03 (Print Publication: 2020). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Published by Oxford University Press on behalf of the Infectious Diseases Society of America Country of Publication: United States NLM ID: 101637045 Publication Model: eCollection Cited Medium: Print ISSN: 2328-8957 (Print) Linking ISSN: 23288957 NLM ISO Abbreviation: Open Forum Infect Dis Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: Cary, NC : Published by Oxford University Press on behalf of the Infectious Diseases Society of America, [2014]- |
| مستخلص: | Background: Although widely accepted for adults, the safety of outpatient parenteral antimicrobial therapy (OPAT) in very old patients has not been examined. Methods: Nonagenarians (age ≥90 years) discharged from the hospital on OPAT over a 5-year period were identified from the Cleveland Clinic OPAT Registry. Three matched controls (<90 years) were selected for each nonagenarian. Times to OPAT-related emergency department (ED) visit and OPAT-related readmission were compared across the 2 groups in multivariable subdistribution proportional hazards competing risks regression models. Incidence of adverse drug events and vascular access complications were compared using negative binomial regression. Results: Of 126 nonagenarians and 378 controls, 7 were excluded for various reasons. Among the remaining 497 subjects, 306 (62%) were male, 311 (63%) were treated for cardiovascular or osteoarticular infections, and 363 (73%) were discharged to a residential health care facility. The mean (SD) ages of nonagenarians and controls were 92 (2) and 62 (16) years, respectively. Compared with matched controls, being a nonagenarian was not associated with increased risk of OPAT-related ED visit (hazard ratio [HR], 0.77; 95% CI, 0.33-1.80; P = .55), OPAT-related readmission (HR, 0.78; 95% CI, 0.28-2.16; P = .63), adverse drug event from OPAT medications (incidence rate ratio [IRR], 1.00; 95% CI, 0.43-2.17; P = .99), or vascular access complications (IRR, 0.66; 95% CI, 0.27-1.51; P = .32). Nonagenarians had a higher risk of death overall (HR, 2.64; 95% CI, 1.52-4.58; P < .001), but deaths were not from OPAT complications. Conclusions: Compared with younger patients, OPAT in nonagenarians is not associated with higher risk of OPAT-related complications. OPAT can be provided as safely to nonagenarians as to younger patients. (© The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.) |
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| فهرسة مساهمة: | Keywords: OPAT; aged 80 and over; emergency service; home infusion therapy; hospital; patient readmission |
| تواريخ الأحداث: | Date Created: 20201009 Latest Revision: 20220417 |
| رمز التحديث: | 20221213 |
| مُعرف محوري في PubMed: | PMC7532659 |
| DOI: | 10.1093/ofid/ofaa398 |
| PMID: | 33033731 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2328-8957 |
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| DOI: | 10.1093/ofid/ofaa398 |