Home Hospitalization Unit of Surgical Patients During the COVID-19 Pandemic
DOI:
https://doi.org/10.22585/hospdomic.v5i1.111Keywords:
Home Care Services, Hospital at home care, SARS- COV2 Virus, COVID-19, Postoperative Care, Surgical patientAbstract
Introduction: current COVID-19 pandemic is testing healthcare systems at a global level. From General Surgery Department we decided to provide a practical strategy for surgical patients’ hospitalization that allowed to treat them as if they were admitted in hospital.
Home Hospitalization is an effective healthcare modality in medical and surgical pathology in which, for a limited time, health practitioners provide active treatment at patient’s home.
The aim of this study is to describe our experience of home care hospitalization in surgical patients during the covid-19 pandemic.
Method: Observational, descriptive, prospective, single-center study. 44 patients admitted to surgical home hospitalization unit from March 11 to May 10 2020. Patients with emergency or elective surgery and surgical patients who required conservative medical treatment or interventionism were included. Epidemiological variables, diagnosis, treatment, mean stay, readmissions rate, complications and mortality were evaluated.
Results: Mean age 64 years ± 16,7 (23-89). 52% men and 49% women. 23 patients underwent emergency or elective surgery, 12 patients conservative medical treatment, 2 thoracic drainage, 5 percutaneous drainage due to intra-abdominal abscesses and 2 patients with negative pressure therapy for surgical wound healing. Mean hospital stay 8,6 days ± 3,6 (1-19).
Five complications were registered: subocclusion, colo-rectal bleeding, subcutaneous emphysema, lung abscess and a COVID-19 infection. Readmissions rate: 4,5%.
Conclusions: Home hospitalization is an effective model to decrease or avoid hospital stay in selected patients. It also appears to be as safe as inpatient hospitalization. Combination of short-stay admission and home admission could be a good therapeutic option in surgical patients.
Downloads
References
Stahel FP. How to risk-stratify elective surgery during the COVID-19 pandemic? Patient Saf Surg 2020;14:8. DOI: 10.1186/s13037-020-00235-9; PMID: 32288785
Flemming S, Hankir M, Ernestus RI, Seyfried F, Germer CT, Meybohm P, et al. Surgery in times of COVID-10 recommendations for hospital and patient management. Langenbecks Arch Surg. 2020;405(3):359–64. DOI: 10.1007/s00423-020-01888; PMID: 32385568
Caplan GA, Sulaiman NS, Mangin DA, Aimonino RN, Wilson AD, Barclay L. A metaanalysis of “hospital in the home”. Med J Aust. 2012;197(9):512-9. DOI: 10.5694/mja12.10480; PMID: 23121588
Álvarez Gallego M, Gortázar de las Casas S, Pascual Migueláñez S, Rubio-Pérez I, Barragán Serrano C, Álvarez Peña E, et al. Impacto de la pandemia por SARS-CoV-2 sobre la actividad y profesionales de un Servicio de Cirugía General y del Aparato Digestivo en un hospital terciario. Cir Esp. 2020;98(6):320-7. DOI: 10.1016/j.ciresp.2020.04.001; PMID: 32336467
Spuch JA, Mirón M, Florit L, Escuder J, Castellote M, Zornoza A. Tratamiento domiciliario de pacientes con fístula pancreática. Cir Esp 2008;83(3):129-33. DOI: 10.1016/S0009-739X(08)70527-X
Salazar A, Estrada C, Porta, Lolo M, Tomas S, Alvarez M. Home hospitalization unit: an alternative to standard inpatient hospitalization from the emergency department. Eur J Emerg Med. 2009;16(3):121-3. DOI: 10.1097/MEJ.0b013e32831cbae2; PMID: 19262397
Varney J, Weiland TJ, Jelinek G. Efficacy of hospital in the home services providing care for patients admitted from emergency departments: an integrative review. Int J Evid Based Healthc. 2014;12(2):128-41. DOI: 10.1097/XEB.0000000000000011; PMID: 24945961
Shepperd S, Doll H, Broad J, Gladman J, Iliffe S, Langhorne P, et al. Early discharge hospital at home. Cochrane Database Syst Rev. 2009;(1):CD000356. DOI: 10.1002/14651858.CD000356.pub3; PMID: 19160179
Millet M, Carrera JA, Garde C, Goenaga M, Arzelus E, Cuende A. Hospitalización a domicilio y uso inadecuado de la hospitalización en cirugía general. Cir Esp. 2006;79(3):194. DOI: 10.1016/S0009-739X(06)70852-1
Dindo D, Demartines N, Clavien PA. Classification of Surgical Complications. A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240(2):205-13. DOI: 10.1097/01.sla.0000133083.54934.ae; PMID: 15273542
Jacobs JM, Hammerman-Rozenberg R, Stessman J. Home Hospitalization: 15 years of experience. Ann Intern Med. 2006;144(6):456. DOI: 10.7326/0003-4819-144-6-200603210-00023; PMID: 16549867
Mias MC, Pérez-Ruiz L, Rodriguez S, Massoni A, Solá R, Ros S. Impacto de la hospitalización a domicilio en la cirugía tiroidea: estudio comparativo con la hospitalización convencional. Rev Calidad Asistencial 2002;17(8):619-23.
Downloads
Additional Files
Published
How to Cite
Issue
Section
License
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons 4.0 BY-NC-SA que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
