Infections and the Posthospital Syndrome
This phenomenon now has a name. The term "posthospital syndrome" has been coined to describe an acquired, transient period of vulnerability to a range of adverse health events.[4] The perturbations associated with acute illness can substantially alter host/pathogen interactions, and often the time and circumstances required for an infection to develop are reached only after discharge. Table 2 lists factors that may contribute to infections after discharge from hospital.
Table 2. Factors That Increase Risk for Infection or Medication Side Effects
| Factor | Resulting Impairment | Possible Outcome |
|---|---|---|
| Surgical procedure | Surgical wounds | Surgical site infection |
| Indwelling catheters | Breaks in anatomic barriers | Catheter-associated infections |
| Encephalopathy and frailty | Aspiration of oropharyngeal contents; skin breakdown | Pneumonia; soft-tissue infections |
| Anesthetics/sedatives | Decreased airway clearance | Pneumonia |
| Corticosteroids and immunosuppressants | Multiple host immune defects | Increased rate and severity of infection |
| Antibiotics | Change in microbiome | CDAD |
| Gastric acid suppression | Change in microbiome | Pneumonia; CDAD[5,6] |
| Malnourishment | Multiple immune defects and impaired wound healing | Increased rate and severity of infection |
| Imprecise medical plan hand-off to caregiver | Underuse or overuse of key medications; failure to monitor for medication side effects | Recrudescent or new infection; drug toxicity[7,8] |
| CDAD = Clostridium difficile-associated disease | ||
Medscape Infectious Diseases © 2015 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Shmuel Shoham. No Return Trips: Hospitals Under Pressure to Lower Readmissions - Medscape - Apr 23, 2015.
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