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Characterization of Patients Who Return to Hospital Following Discharge from Hospitalization for COVID-19
BACKGROUND: Data on patients with coronavirus disease 2019 (COVID-19) who return to hospital after discharge are scarce. Characterization of these patients may inform post-hospitalization care. OBJECTIVE: To describe clinical characteristics of patients with COVID-19 who returned to the emergency de...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7437962/ https://www.ncbi.nlm.nih.gov/pubmed/32815060 http://dx.doi.org/10.1007/s11606-020-06120-6 |
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author | Somani, Sulaiman S. Richter, Felix Fuster, Valentin De Freitas, Jessica K. Naik, Nidhi Sigel, Keith Bottinger, Erwin P Levin, Matthew A. Fayad, Zahi Just, Allan C. Charney, Alexander W. Zhao, Shan Glicksberg, Benjamin S. Lala, Anuradha Nadkarni, Girish N. |
author_facet | Somani, Sulaiman S. Richter, Felix Fuster, Valentin De Freitas, Jessica K. Naik, Nidhi Sigel, Keith Bottinger, Erwin P Levin, Matthew A. Fayad, Zahi Just, Allan C. Charney, Alexander W. Zhao, Shan Glicksberg, Benjamin S. Lala, Anuradha Nadkarni, Girish N. |
author_sort | Somani, Sulaiman S. |
collection | PubMed |
description | BACKGROUND: Data on patients with coronavirus disease 2019 (COVID-19) who return to hospital after discharge are scarce. Characterization of these patients may inform post-hospitalization care. OBJECTIVE: To describe clinical characteristics of patients with COVID-19 who returned to the emergency department (ED) or required readmission within 14 days of discharge. DESIGN: Retrospective cohort study of SARS-COV-2-positive patients with index hospitalization between February 27 and April 12, 2020, with ≥ 14-day follow-up. Significance was defined as P < 0.05 after multiplying P by 125 study-wide comparisons. PARTICIPANTS: Hospitalized patients with confirmed SARS-CoV-2 discharged alive from five New York City hospitals. MAIN MEASURES: Readmission or return to ED following discharge. RESULTS: Of 2864 discharged patients, 103 (3.6%) returned for emergency care after a median of 4.5 days, with 56 requiring inpatient readmission. The most common reason for return was respiratory distress (50%). Compared with patients who did not return, there were higher proportions of COPD (6.8% vs 2.9%) and hypertension (36% vs 22.1%) among those who returned. Patients who returned also had a shorter median length of stay (LOS) during index hospitalization (4.5 [2.9,9.1] vs 6.7 [3.5, 11.5] days; P(adjusted) = 0.006), and were less likely to have required intensive care on index hospitalization (5.8% vs 19%; P(adjusted) = 0.001). A trend towards association between absence of in-hospital treatment-dose anticoagulation on index admission and return to hospital was also observed (20.9% vs 30.9%, P(adjusted) = 0.06). On readmission, rates of intensive care and death were 5.8% and 3.6%, respectively. CONCLUSIONS: Return to hospital after admission for COVID-19 was infrequent within 14 days of discharge. The most common cause for return was respiratory distress. Patients who returned more likely had COPD and hypertension, shorter LOS on index-hospitalization, and lower rates of in-hospital treatment-dose anticoagulation. Future studies should focus on whether these comorbid conditions, longer LOS, and anticoagulation are associated with reduced readmissions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11606-020-06120-6) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-7437962 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-74379622020-08-20 Characterization of Patients Who Return to Hospital Following Discharge from Hospitalization for COVID-19 Somani, Sulaiman S. Richter, Felix Fuster, Valentin De Freitas, Jessica K. Naik, Nidhi Sigel, Keith Bottinger, Erwin P Levin, Matthew A. Fayad, Zahi Just, Allan C. Charney, Alexander W. Zhao, Shan Glicksberg, Benjamin S. Lala, Anuradha Nadkarni, Girish N. J Gen Intern Med Original Research BACKGROUND: Data on patients with coronavirus disease 2019 (COVID-19) who return to hospital after discharge are scarce. Characterization of these patients may inform post-hospitalization care. OBJECTIVE: To describe clinical characteristics of patients with COVID-19 who returned to the emergency department (ED) or required readmission within 14 days of discharge. DESIGN: Retrospective cohort study of SARS-COV-2-positive patients with index hospitalization between February 27 and April 12, 2020, with ≥ 14-day follow-up. Significance was defined as P < 0.05 after multiplying P by 125 study-wide comparisons. PARTICIPANTS: Hospitalized patients with confirmed SARS-CoV-2 discharged alive from five New York City hospitals. MAIN MEASURES: Readmission or return to ED following discharge. RESULTS: Of 2864 discharged patients, 103 (3.6%) returned for emergency care after a median of 4.5 days, with 56 requiring inpatient readmission. The most common reason for return was respiratory distress (50%). Compared with patients who did not return, there were higher proportions of COPD (6.8% vs 2.9%) and hypertension (36% vs 22.1%) among those who returned. Patients who returned also had a shorter median length of stay (LOS) during index hospitalization (4.5 [2.9,9.1] vs 6.7 [3.5, 11.5] days; P(adjusted) = 0.006), and were less likely to have required intensive care on index hospitalization (5.8% vs 19%; P(adjusted) = 0.001). A trend towards association between absence of in-hospital treatment-dose anticoagulation on index admission and return to hospital was also observed (20.9% vs 30.9%, P(adjusted) = 0.06). On readmission, rates of intensive care and death were 5.8% and 3.6%, respectively. CONCLUSIONS: Return to hospital after admission for COVID-19 was infrequent within 14 days of discharge. The most common cause for return was respiratory distress. Patients who returned more likely had COPD and hypertension, shorter LOS on index-hospitalization, and lower rates of in-hospital treatment-dose anticoagulation. Future studies should focus on whether these comorbid conditions, longer LOS, and anticoagulation are associated with reduced readmissions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11606-020-06120-6) contains supplementary material, which is available to authorized users. Springer International Publishing 2020-08-19 2020-10 /pmc/articles/PMC7437962/ /pubmed/32815060 http://dx.doi.org/10.1007/s11606-020-06120-6 Text en © Society of General Internal Medicine 2020 |
spellingShingle | Original Research Somani, Sulaiman S. Richter, Felix Fuster, Valentin De Freitas, Jessica K. Naik, Nidhi Sigel, Keith Bottinger, Erwin P Levin, Matthew A. Fayad, Zahi Just, Allan C. Charney, Alexander W. Zhao, Shan Glicksberg, Benjamin S. Lala, Anuradha Nadkarni, Girish N. Characterization of Patients Who Return to Hospital Following Discharge from Hospitalization for COVID-19 |
title | Characterization of Patients Who Return to Hospital Following Discharge from Hospitalization for COVID-19 |
title_full | Characterization of Patients Who Return to Hospital Following Discharge from Hospitalization for COVID-19 |
title_fullStr | Characterization of Patients Who Return to Hospital Following Discharge from Hospitalization for COVID-19 |
title_full_unstemmed | Characterization of Patients Who Return to Hospital Following Discharge from Hospitalization for COVID-19 |
title_short | Characterization of Patients Who Return to Hospital Following Discharge from Hospitalization for COVID-19 |
title_sort | characterization of patients who return to hospital following discharge from hospitalization for covid-19 |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7437962/ https://www.ncbi.nlm.nih.gov/pubmed/32815060 http://dx.doi.org/10.1007/s11606-020-06120-6 |
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