Clinical Outcomes and Predictors of Adverse Events in Influenza Patients Managed in a Hospital-at-Home Program: A 10-Year Retrospective Study.
Renal impairment and early emergency room visits are important predictors of adverse outcomes in influenza patients managed at home.
Where it sits
this study against the rest of the eloralintide corpusSummary and findings
This study analyzed clinical outcomes in 270 adult patients with laboratory-confirmed influenza managed in a hospital-at-home program over 10 seasons. The study measured emergency room visits, hospital readmissions, and all-cause mortality at 30 and 90 days. Key predictors of adverse outcomes included reduced glomerular filtration rate and early emergency room visits.
Abstract
<h4>Background</h4>Hospital-at-home (HaH) is increasingly used to manage acute conditions like influenza, but data on long-term outcomes remain limited.<h4>Objective</h4>To identify clinical predictors of 30- and 90-day adverse outcomes among influenza patients treated at HaH.<h4>Methods</h4>We retrospectively analyzed 270 adult patients with laboratory-confirmed influenza managed at HaH over 10 influenza seasons. Outcomes included emergency room (ER) visits, hospital readmissions, and all-cause mortality at 30 and 90 days.<h4>Results</h4>At 30 days, 12.4% had ED visits, 5.1% were readmitted, and 3.4% died; at 90 days, these increased to 16.2%, 6.5%, and 6.8%, respectively. Multivariable analysis identified reduced glomerular filtration rate (GFR < 60 mL/min/1.73 m²) at discharge and early ER visits as independent predictors of poor outcomes.<h4>Conclusions</h4>Renal impairment and early postdischarge ER use are significant predictors of adverse outcomes in influenza patients managed through HaH. These findings help clinicians optimize risk stratification and follow-up strategies during seasonal influenza peaks.
Background
The study addresses the management of influenza patients in a hospital-at-home setting, which is becoming more common for acute conditions. Previous research has shown limited long-term outcomes for patients treated in this manner. Understanding predictors of adverse outcomes is crucial for optimizing patient care and resource allocation during influenza seasons.
Methods
This was a retrospective analysis of 270 adult patients with laboratory-confirmed influenza treated in a hospital-at-home program over 10 influenza seasons. The primary outcomes measured were emergency room visits, hospital readmissions, and all-cause mortality at 30 and 90 days post-discharge.
Results
At 30 days, 12.4% of patients had emergency department visits, 5.1% were readmitted, and 3.4% died. At 90 days, these figures increased to 16.2% for ED visits, 6.5% for readmissions, and 6.8% for mortality. Multivariable analysis identified reduced glomerular filtration rate (GFR < 60 mL/min/1.73 m²) at discharge and early ER visits as independent predictors of poor outcomes.
Interpretation
The findings suggest that renal impairment and early emergency room visits are significant predictors of adverse outcomes in influenza patients managed at home. While the results are statistically significant, the clinical significance of the effect sizes should be interpreted cautiously. Limitations such as the retrospective nature of the study and potential confounding factors may affect the reliability of the conclusions drawn.
Key findings
- 12.4% had ED visits at 30 days, n=270.
- 5.1% were readmitted at 30 days, n=270.
- 3.4% died at 30 days, n=270.
- 16.2% had ED visits at 90 days, n=270.
- 6.5% were readmitted at 90 days, n=270.
- 6.8% died at 90 days, n=270.
Limitations
- retrospective analysis may introduce bias
- potential confounding factors not accounted for
- single-site study limits generalizability