ED Visits Result in Infections for Elderly LTC Residents

Elderly patients who have visited an emergency department (ED) are three times more likely to develop respiratory or gastrointestinal infections in the week following their return to a long-term care facility, such as a Centre d'Hébergement de Soins de Longue Durée (CHLSD). These are the findings of a new Canadian study published in the Canadian Medical Association Journal today.

"There certainly seems to be a benefit to isolating residents in the seven days following their return to a long-term care facility, says Dr. Caroline Quach, an infectious disease specialist from the McGill University Health Centre (MUHC) and the Research Institute of the MUHC and lead author of the study. "In addition to endangering other residents' health, outbreaks generate a significant workload and financial cost to the healthcare facility."

The study, which was conducted from September 2006 to May 2008, involved more than 1,200 residents of 22 different long-term care facilities in Quebec and Ontario. ED visits took place during the winter months, when respiratory and gastrointestinal infections are most likely.

"Following their visit to the ED during the winter, residents were three times more likely to develop symptoms of new infection, and this only in the absence of other infectious disease outbreaks in their CHLSDs," says Quach. "Our challenge as health professionals is to enhance our ongoing efforts in the implementation of and adherence to, infection control policies. We also may want to take further infection control measures upon the return of residents in CHLSDs."

"Infection control has been a major priority in our planning for the Glen site," says Jean-Marc Troquet, chief of emergency medicine at the MUHC adult sites. "The results of this study confirm what we all suspected and validate our decision to design the ED at the Glen with individual patient rooms."

The study, "Risk of infection following a visit to the emergency department: a cohort study," was coauthored by Caroline Quach (MUHC/McGill/INSPQ); Margaret McArthur and Allison McGeer (Mount Sinai Hospital, University of Toronto), Lynne Li (MUHC/McGill); Andrew Simor (Sunnybrook Health Sciences Center, University of Toronto); Marc Dionne (INSPQ); Edith Lévesque (CSSS, Rivière-du-Loup); Lucie Tremblay (Maimonides Geriatric Center, Montreal).

This work was supported by funds from The Canadian Patient Safety Institute (CPSI), the Quebec Ministry of Health and the Canadian Institutes for Health Research (CIHR).