Study: ER visits triple the risk of infection for nursing home residents

A visit to the emergency department during non-summer months was associated with a three-fold risk of acute respiratory or gastrointestinal infection in elderly residents of Canadian LTC facilities, according to a study in Canadian Medical Association Journal.

The study involved 1269 elderly residents of 22 LTC facilities in the Greater Toronto Area, Ontario; and Montréal and Rivière-du-Loup, Quebec. Of those residents during the study period from September 2006 to May 2008, 424 residents visited emergency departments for a variety of conditions—excluding acute respiratory and gastrointestinal symptoms—and 845 did not visit emergency.

For people who visited an emergency department, there was a three-fold risk of contracting a respiratory or gastrointestinal infection, with an incidence of infection of 8.3/1000 resident-days in this group compared with 3.4/1000 resident-days in the unexposed group.

“In our study, a visit to the emergency department between September and May was associated with increased risk of a new respiratory or gastrointestinal infection in the week following the visit, but only in the absence of an outbreak in the resident's facility,” researchers with Montreal Children's Hospital said.

The study participants had a higher rate of chronic illnesses and were more likely to be less independent than residents who were not exposed to emergency departments. The researchers focused on visits during non-summer months as there is a higher rate of respiratory and gastrointestinal infections during these months.

Researchers suggested further study into the systemic reasons for the transmission of infection in emergency departments, as well as interventions to reduce risks.

“In the meantime, considerations should be given to the implementation of additional precautions for residents for five to seven days after their return from the emergency department,” researchers said.