SHM Converge Scientific Abstract ePoster Gallery-Patient Characteristics and Clinical Outcomes of Acute Pyelonephritis Treated in Hospital at Home Program

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This multicenter retrospective study evaluated adults with acute pyelonephritis (AP) treated in Mayo Clinic’s Advanced Care at Home program from July 2020 to January 2025. Among 165 patients, the cohort was medically complex: median age was 67, median Charlson Comorbidity Index was 5, and all had underlying genitourinary conditions. Illness severity was high, with most patients classified as moderate-to-major severity of illness and risk of mortality. On admission, 30.9% met sepsis criteria, 47.3% had acute kidney injury, and 33.3% developed bacteremia.<br /><br />Despite this acuity, outcomes were favorable. Median length of stay in the hospital-at-home program was 3.1 days. Only 4.8% of patients required escalation to a traditional hospital, 17.0% were readmitted within 30 days, and 4.8% had a 30-day emergency department visit. No deaths occurred during the program.<br /><br />The study suggests that acute pyelonephritis, even when complicated by sepsis, bacteremia, or kidney injury, can be managed safely and effectively at home when patients are carefully selected and supported by robust infrastructure. Key program elements included frequent reassessment, remote monitoring, protocolized sepsis pathways, same-day treatment adjustments, and rapid paramedic response.<br /><br />The authors note that this is the first detailed U.S. multicenter description focused specifically on AP outcomes in a hospital-at-home setting. However, the retrospective design and reliance on electronic health records limit causal conclusions. Prospective studies are needed to better define ideal patient selection and optimize home-based care for complex infections.

Asset Subtitle

Igor Dumic

Meta Tag

Author List Igor Dumic, Margaret R. Paulson, Michael J. Maniaci, Wendelyn Bosch

Category Research

Concept Pyelonephritis

Concept Hospital-at-Home

Concept Retrospective Cohort Study

Concept Advanced Care at Home Program

Concept Protocolized Monitoring

Distinguished Non-Finalist

Presenter Organization Mayo Clinic College of Medicine and Science, Rochester, MN, USA

Presenting Author Igor Dumic

Track Patient Safety

Keywords

acute pyelonephritis

hospital-at-home

multicenter retrospective study

Mayo Clinic

sepsis

bacteremia

acute kidney injury

remote monitoring

genitourinary conditions

patient outcomes

Pyelonephritis

Hospital-at-Home

Retrospective Cohort Study

Advanced Care at Home Program

Protocolized Monitoring