Table 3.
OPAT Outcomes and Predictors of Unfavorable Outcomes at 90 Days for OPAT Patients
| Overall | Skilled Nursing Facility | Home Health | P Value | ||||
|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | ||
| (n = 107) | (n = 41) | (n = 66) | |||||
| OPAT-related adverse events (90 d postdischarge) | 37 | 34.6 | 15 | 36.6 | 23 | 34.8 | .99 |
| Total patients with adverse events | 35 | 32.7 | 12 | 29.3 | 23 | 34.8 | .70 |
| Readmission for adverse event | 17 | 15.9 | 5 | 12.2 | 12 | 18.2 | .58 |
| Type of adverse event | |||||||
| Adverse drug events | 26 | 24.3 | 7 | 17.1 | 19 | 28.8 | .25 |
| Therapy modified or discontinued for ADE | 16 | 15.0 | 7 | 17.1 | 9 | 13.6 | .84 |
| Line related | 8 | 7.5 | 7 | 17.1 | 1 | 1.5 | .01 |
| Line infection | 8 | 7.5 | 6 | 14.6 | 2 | 3.0 | .05 |
| Noninfectious line complication | 1 | 0.9 | 1 | 2.4 | 0 | 0.0 | - |
| Clostridium difficile infection | 3 | 2.8 | 1 | 2.4 | 2 | 3.0 | .80 |
| Treatment outcomes | |||||||
| At end of OPAT therapy | |||||||
| Favorable | 86 | 80.4 | 31 | 75.6 | 55 | 83.3 | .47 |
| Cure | 68 | 63.6 | 26 | 63.4 | 42 | 63.6 | .99 |
| Suppression | 18 | 16.8 | 5 | 12.2 | 13 | 19.7 | .46 |
| Unfavorable | 14 | 13.1 | 5 | 12.2 | 9 | 13.6 | .99 |
| At 90 d postdischarge | |||||||
| Favorable | 71 | 66.4 | 25 | 61.0 | 46 | 69.7 | .47 |
| Cure | 56 | 52.3 | 21 | 51.2 | 35 | 53.0 | .99 |
| Suppression | 15 | 14.0 | 4 | 9.8 | 11 | 16.7 | .47 |
| Unfavorable | 20 | 18.7 | 9 | 22.0 | 11 | 16.7 | .67 |
| Lost to follow-up | 9 | 8.4 | 7 | 17.1 | 2 | 3.0 | .03 |
| Relapse | 22 | 20.6 | 6 | 14.6 | 15 | 22.7 | .44 |
| Death | 6 | 5.6 | 2 | 4.9 | 4 | 6.1 | .99 |
| Readmission rates | |||||||
| 30-d readmissions | 34 | 31.8 | 12 | 29.3 | 22 | 33.3 | .82 |
| 90-d readmissions | 64 | 59.8 | 21 | 51.2 | 43 | 65.2 | .22 |
| OPAT-related 90-d readmissions | 34 | 31.8 | 13 | 31.7 | 21 | 31.8 | .99 |
| Worsening or relapsing infection | 17 | 15.9 | 7 | 17.1 | 10 | 15.2 | .99 |
| Adverse drug event | 8 | 7.5 | 1 | 2.4 | 7 | 10.6 | .15 |
| Line complication | 6 | 5.6 | 4 | 9.8 | 2 | 3.0 | .20 |
| Sequelae of original infection | 2 | 1.9 | 1 | 2.4 | 1 | 1.5 | .99 |
| Planned surgery | 1 | 0.9 | 0 | 0.0 | 1 | 1.5 | - |
| OPAT-unrelated readmissions | 30 | 28.0 | 8 | 19.5 | 22 | 33.3 | .18 |
| Multivariable model of predictors of unfavorable outcome at 90 days. Model is adjusted for the variables listed. | |||||||
| Variable | Adjusted Odds Ratios | 95% CI | P Value | ||||
| Male gender | 0.23 | (0.07–0.73) | .013 | ||||
| Age | 1.00 | (0.97–1.03) | .955 | ||||
| Mental illness | 2.22 | (0.71–6.96) | .173 | ||||
| APRDRG severity subclass (compared with 2) | |||||||
| 3 | 1.28 | (0.27–6.10) | .759 | ||||
| 4 | 5.36 | (1.27–22.74) | .023 | ||||
| MSRA vs MSSA | 1.22 | (0.43–3.47) | .708 | ||||
| Treating facility (SNF vs HHC) | 0.66 | (0.22–1.98) | .459 | ||||
Abbreviations: ADE, adverse drug event; APRDRG, All-Patient Refined Diagnosis-Related Group; CI, confidence interval; HHC, home health company; MRSA, methicillin-resistant Staphylococcus aureus; MSSA, methicillin-sensitive Staphylococcus aureus; OPAT, outpatient parenteral antibiotic therapy; SNF, skilled nursing facility.