TY - JOUR
T1 - Risk Factors for Complications during Outpatient Parenteral Antimicrobial Therapy for Adult Orthopedic and Neurosurgical Infections
AU - Felder, Kimberly K.
AU - Marshall, Lynn M.
AU - Vaz, Louise E.
AU - Barnes, Penelope D.
N1 - Funding Information:
This study was supported by an Oregon Clinical and Translational Research Institute grant (1 UL1 RR024140 01) for the use of REDCAP, a secure Web-based data collection tool for research purposes. The authors thank Matthew DeHart for contributions to data collection, and Cynthia Morris, PhD, MPH, Mike Lasarev, MS, Jodi Lapidus, PhD, and Dawn Peters, PhD, instructors in the OHSU Human Investigations Program, for guidance regarding study design and statistical methods.
Publisher Copyright:
© 2015 The Southern Medical Association.
Copyright:
Copyright 2016 Elsevier B.V., All rights reserved.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Objectives: Outpatient parenteral antimicrobial therapy (OPAT) is an effective way of treating infections, but complications are common. We identified patient characteristics and OPAT treatment factors associated with increased risk of OPAT-related complications. Methods: We used a retrospective cohort design that assessed 337 adult patients treated with OPAT for orthopedic and neurosurgical infections between August 1, 2008 and May 30, 2010. Independent variables included demographics, infection characteristics, lead time factors, OPAT treatment factors, and comorbid conditions. Multivariable log-binomial regression was used to estimate the risk of OPAT complications. Results: The mean patient age was 55 years (range 19Y87), 86% had an orthopedic infection, and 44% were treated with intravenous vancomycin. OPAT complications were seen in 45% (152/337) of the cohort. Risk ratios for OPAT complications were 1.9 (95% confidence interval 1.4Y2.5) in patients having no primary care provider, 1.7 (95% confidence interval 1.3Y2.1) for those treated with vancomycin.
AB - Objectives: Outpatient parenteral antimicrobial therapy (OPAT) is an effective way of treating infections, but complications are common. We identified patient characteristics and OPAT treatment factors associated with increased risk of OPAT-related complications. Methods: We used a retrospective cohort design that assessed 337 adult patients treated with OPAT for orthopedic and neurosurgical infections between August 1, 2008 and May 30, 2010. Independent variables included demographics, infection characteristics, lead time factors, OPAT treatment factors, and comorbid conditions. Multivariable log-binomial regression was used to estimate the risk of OPAT complications. Results: The mean patient age was 55 years (range 19Y87), 86% had an orthopedic infection, and 44% were treated with intravenous vancomycin. OPAT complications were seen in 45% (152/337) of the cohort. Risk ratios for OPAT complications were 1.9 (95% confidence interval 1.4Y2.5) in patients having no primary care provider, 1.7 (95% confidence interval 1.3Y2.1) for those treated with vancomycin.
KW - OPAT complications
KW - neurosurgical infection
KW - orthopedic infection
KW - outpatient parenteral antibiotic therapy (OPAT)
KW - risk factors
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U2 - 10.14423/SMJ.0000000000000401
DO - 10.14423/SMJ.0000000000000401
M3 - Article
C2 - 26741876
AN - SCOPUS:84953303238
VL - 109
SP - 53
EP - 60
JO - Southern Medical Journal
JF - Southern Medical Journal
SN - 0038-4348
IS - 1
ER -