Cargando…
Pre-Hospital Management of Patients with COVID-19 and the Impact on Hospitalization
Background and Objectives: During the COVID-19 pandemic, patient care was mainly organized around the hospital. Pre-hospital care has, to our knowledge, never been evaluated. We aimed to study the impact of pre-hospital pathways on hospitalization during the last part of the pandemic. Materials and...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456276/ https://www.ncbi.nlm.nih.gov/pubmed/37629730 http://dx.doi.org/10.3390/medicina59081440 |
_version_ | 1785096657561452544 |
---|---|
author | Grannec, Floann Meddeb, Line Tissot-Dupont, Herve Gentile, Stephanie Brouqui, Philippe |
author_facet | Grannec, Floann Meddeb, Line Tissot-Dupont, Herve Gentile, Stephanie Brouqui, Philippe |
author_sort | Grannec, Floann |
collection | PubMed |
description | Background and Objectives: During the COVID-19 pandemic, patient care was mainly organized around the hospital. Pre-hospital care has, to our knowledge, never been evaluated. We aimed to study the impact of pre-hospital pathways on hospitalization during the last part of the pandemic. Materials and Methods: This was a monocentric, retrospective analysis of prospectively collected medical records. Data from patients admitted to our institute between 1 February and 7 March 2022 were analyzed. The primary outcomes were defined as the number of hospitalizations, resuscitations, and deaths at the time of interview and in the subsequent 30 days. The main explanatory variables were times from onset of symptoms to care, age, gender, News2 score, comorbidities, and pre-hospital pathways and their duration. Results: Three pre-hospital pathways were identified: a pathway in which the patient consults a general practitioner for a test (PHP1); a pathway in which the patient consults for care (PHP2); and no pre-hospital pathway and direct admission to hospital (PHP3). Factors independently associated with outcome (hospitalization) were being male (OR 95% CI; 2.21 (1.01–4.84), p = 0,04), News2 score (OR 95% CI; 2.04 (1.65–2.51), p < 0.001), obesity (OR 95% CI; 3.45 (1.48–8.09), p = 0.005), D-dimers > 0.5 µg/mL (OR 95% CI; 3.45 (1.47–8.12), p = 0.005), and prolonged time from symptoms to hospital care (PHP duration) (OR 95% CI; 1.07 (1.01–1.14), p = 0.03). All things being equal, patients with a “PHP2” pre-hospital pathway had a higher probability of hospitalization compared to those with a “PHP3” pre-hospital pathway (OR 95% CI; 4.31 (1.48–12.55), p = 0.007). Conclusions: Along with recognized risk factors such as gender, News 2 score, and obesity, the patient’s pre-hospital pathway is an important risk factor associated with hospitalization. |
format | Online Article Text |
id | pubmed-10456276 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-104562762023-08-26 Pre-Hospital Management of Patients with COVID-19 and the Impact on Hospitalization Grannec, Floann Meddeb, Line Tissot-Dupont, Herve Gentile, Stephanie Brouqui, Philippe Medicina (Kaunas) Article Background and Objectives: During the COVID-19 pandemic, patient care was mainly organized around the hospital. Pre-hospital care has, to our knowledge, never been evaluated. We aimed to study the impact of pre-hospital pathways on hospitalization during the last part of the pandemic. Materials and Methods: This was a monocentric, retrospective analysis of prospectively collected medical records. Data from patients admitted to our institute between 1 February and 7 March 2022 were analyzed. The primary outcomes were defined as the number of hospitalizations, resuscitations, and deaths at the time of interview and in the subsequent 30 days. The main explanatory variables were times from onset of symptoms to care, age, gender, News2 score, comorbidities, and pre-hospital pathways and their duration. Results: Three pre-hospital pathways were identified: a pathway in which the patient consults a general practitioner for a test (PHP1); a pathway in which the patient consults for care (PHP2); and no pre-hospital pathway and direct admission to hospital (PHP3). Factors independently associated with outcome (hospitalization) were being male (OR 95% CI; 2.21 (1.01–4.84), p = 0,04), News2 score (OR 95% CI; 2.04 (1.65–2.51), p < 0.001), obesity (OR 95% CI; 3.45 (1.48–8.09), p = 0.005), D-dimers > 0.5 µg/mL (OR 95% CI; 3.45 (1.47–8.12), p = 0.005), and prolonged time from symptoms to hospital care (PHP duration) (OR 95% CI; 1.07 (1.01–1.14), p = 0.03). All things being equal, patients with a “PHP2” pre-hospital pathway had a higher probability of hospitalization compared to those with a “PHP3” pre-hospital pathway (OR 95% CI; 4.31 (1.48–12.55), p = 0.007). Conclusions: Along with recognized risk factors such as gender, News 2 score, and obesity, the patient’s pre-hospital pathway is an important risk factor associated with hospitalization. MDPI 2023-08-09 /pmc/articles/PMC10456276/ /pubmed/37629730 http://dx.doi.org/10.3390/medicina59081440 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Grannec, Floann Meddeb, Line Tissot-Dupont, Herve Gentile, Stephanie Brouqui, Philippe Pre-Hospital Management of Patients with COVID-19 and the Impact on Hospitalization |
title | Pre-Hospital Management of Patients with COVID-19 and the Impact on Hospitalization |
title_full | Pre-Hospital Management of Patients with COVID-19 and the Impact on Hospitalization |
title_fullStr | Pre-Hospital Management of Patients with COVID-19 and the Impact on Hospitalization |
title_full_unstemmed | Pre-Hospital Management of Patients with COVID-19 and the Impact on Hospitalization |
title_short | Pre-Hospital Management of Patients with COVID-19 and the Impact on Hospitalization |
title_sort | pre-hospital management of patients with covid-19 and the impact on hospitalization |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456276/ https://www.ncbi.nlm.nih.gov/pubmed/37629730 http://dx.doi.org/10.3390/medicina59081440 |
work_keys_str_mv | AT grannecfloann prehospitalmanagementofpatientswithcovid19andtheimpactonhospitalization AT meddebline prehospitalmanagementofpatientswithcovid19andtheimpactonhospitalization AT tissotdupontherve prehospitalmanagementofpatientswithcovid19andtheimpactonhospitalization AT gentilestephanie prehospitalmanagementofpatientswithcovid19andtheimpactonhospitalization AT brouquiphilippe prehospitalmanagementofpatientswithcovid19andtheimpactonhospitalization |