Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 1:10:20499361231195966.
doi: 10.1177/20499361231195966. eCollection 2023 Jan-Dec.

An evaluation of risk factors for readmission in patients receiving outpatient parenteral antimicrobial therapy

Abby C Bradley  1   2 , Mary Joyce B Wingler  3 , Katherine L Artman  1 , Lori M Ward  4 , Jose Lucar  5   6
Affiliations

An evaluation of risk factors for readmission in patients receiving outpatient parenteral antimicrobial therapy

Abby C Bradley et al. Ther Adv Infect Dis. .

Abstract

Background: Outpatient parenteral antimicrobial therapy (OPAT), when required, is beneficial to patients and healthcare systems by reducing hospital length-of-stay, providing cost savings, and improving patient satisfaction.

Objectives: The purpose of this study is to determine readmission rates and associated risk factors in patients receiving OPAT at home.

Methods: This retrospective study included hospitalized patients 15 years and older who were discharged on intravenous antimicrobial therapy via OPAT at home between January 2018 and December 2019. Patients receiving antimicrobials at a skilled nursing facility, long-term acute care, or dialysis center, and those who began OPAT at home directly from the outpatient setting were excluded. The primary outcome of this study was all-cause 30-day readmission rate. Secondary outcomes included 90-day readmission rate, rates of complications related to OPAT, emergency department visits during OPAT, and predictors of all-cause 30-day readmission through a logistic regression analysis.

Results: Two hundred individual patients were included in the analysis; 60% were male and the mean age was 49 years. The most common indications for OPAT at home were bone and joint infection (52%) and bacteremia (26%). Forty patients (20%) experienced an unplanned, all-cause 30-day readmission, with a total of 48 readmission events. Of the 40 patients who were readmitted within 30 days, 20 (50%) were due to non-OPAT related reasons. Sixty patients (30%) experienced an OPAT-related complication, and chronic kidney disease was found to be an independent predictor of readmission (OR: 2.8, 95% CI: 1.0-7.6).

Conclusions: Patients receiving OPAT at home are at increased risk for early hospital readmission, but it is often due to reasons not associated with OPAT. Patients with chronic kidney disease beginning OPAT at home should be closely monitored after discharge.

Keywords: OPAT; antimicrobial management; home infusion; readmission; risk factors.

PubMed Disclaimer

Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Study enrollment. IV, intravenous; OPAT, outpatient parenteral antimicrobial therapy; PICC, peripherally inserted central catheter.
See this image and copyright information in PMC

References

    1. Laupland KB, Valiquette L. Outpatient parenteral antimicrobial therapy. Can J Infect Dis Med Microbiol 2013; 24: 9–11. - PMC - PubMed
    1. Tice AD, Rehm S, Dalovisio JR, et al.. Practice guidelines for outpatient parenteral antimicrobial therapy. Clin Infect Dis 2004; 38: 1651–1672. - PubMed
    1. Paladino JA, Poretz D. Outpatient parenteral antimicrobial therapy today. Clin Infect Dis 2010; 51: S198–S208. - PubMed
    1. Keller SC, Williams D, Gavgani M, et al.. Rates of and risk factors for adverse drug events in outpatient parenteral antimicrobial therapy. Clin Infect Dis 2018; 66: 11–19. - PMC - PubMed
    1. Madaline T, Nori P, Mowrey W, et al.. Bundle in the Bronx: impact of a transition-of-care outpatient parenteral antibiotic therapy bundle on all-cause 30-day hospital readmissions. Open Forum Infect Dis 2017; 4: ofx097. - PMC - PubMed

LinkOut - more resources