Prognosis of home-cared or hospital-treated acute fever in older adults: A prospective multicenter case-control study.

Aims: This study aimed to investigate the differences in the prognosis of older patients who received home care or hospitalized care to treat acute fever in Japan.

Methods: This prospective case-control study screened 192 registered acutely pyrexic older patients who received home care at 10 medical institutions in Japan, and enrolled 15 and 30 patients who were treated in the hospital (hospitalized group) and at home (home-care group), respectively, matched for fever and the physical conditions before fever onset. Intergroup differences in the 90-day mortality from fever onset and changes in patients' disability and dementia from the pre-fever to 90 days post-fever onset were determined.

Results: No significant intergroup difference in the 90-day mortality rate was detected (26.7% vs 13.3% for hospitalized and home-care groups, respectively, P = 0.41). Disability tended to worsen in the hospitalized group compared with the home-care group (54.5% vs 23.1%, respectively, P = 0.06), whereas dementia significantly worsened in the hospitalized group compared with the home-care group (45.5% vs 3.8%, respectively, P = 0.02).

Conclusions: Home care confers a better prognosis for treating acute fever in older people whose daily functions have deteriorated enough to necessitate regular home care. This study assists those people in making informed choices about where to receive treatment for acute fever. Geriatr Gerontol Int 2023; 23: 355-361.