Cargando…
Predictors of readmission requiring hospitalization after discharge from emergency departments in patients with COVID-19
INTRODUCTION: Little is known on prevalence of early return hospital admission of subjects with COVID-19 previously evaluated and discharged from emergency departments (EDs). This study aims to describe readmission rate within 14 days of patients with COVID-19 discharged from ED and to identify pred...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Inc.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061182/ https://www.ncbi.nlm.nih.gov/pubmed/33932638 http://dx.doi.org/10.1016/j.ajem.2021.04.055 |
_version_ | 1783681514478764032 |
---|---|
author | Menditto, Vincenzo G. Fulgenzi, Francesca Bonifazi, Martina Gnudi, Umberto Gennarini, Silvia Mei, Federico Salvi, Aldo |
author_facet | Menditto, Vincenzo G. Fulgenzi, Francesca Bonifazi, Martina Gnudi, Umberto Gennarini, Silvia Mei, Federico Salvi, Aldo |
author_sort | Menditto, Vincenzo G. |
collection | PubMed |
description | INTRODUCTION: Little is known on prevalence of early return hospital admission of subjects with COVID-19 previously evaluated and discharged from emergency departments (EDs). This study aims to describe readmission rate within 14 days of patients with COVID-19 discharged from ED and to identify predictors of return hospital admission. METHODS: We performed a retrospective cohort study of adult patients with COVID-19 discharged from two EDs. Return hospital admission was defined as an unscheduled return ED visit within 14 days after initial ED evaluation and discharge. We compared the group of patients who had a return hospital admission to those who did not. We also evaluated selected clinical characteristics (age, neutrophilia, SOFA, lactate dehydrogenase, C-reactive protein and D-dimer) associated with return hospital admission. RESULTS: Of 283 patients included in the study, 65 (22.9%) had a return ED visit within 14 days. 32 of those patients (11%) were then hospitalized, while the remaining 33 were again discharged. Patients requiring a return hospital admission was significantly older, had higher pro-calcitonin and D-dimer levels. Major predictors of return hospital admission were cognitive impairment (OR 17.3 [CI 4.7–63.2]), P/F < 300 mmHg (OR 8.6 [CI 1.6–44.3]), being resident in geriatric care facility (OR 7.6 [CI 2.1–26.4]) and neutrophilia (OR 5.8 [CI 1.6–22.0]). CONCLUSION: Several factors are associated with 14-day return hospital admission in COVID-19 subjects. These should be considered when assessing discharge risk in ED clinical practice. |
format | Online Article Text |
id | pubmed-8061182 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-80611822021-04-23 Predictors of readmission requiring hospitalization after discharge from emergency departments in patients with COVID-19 Menditto, Vincenzo G. Fulgenzi, Francesca Bonifazi, Martina Gnudi, Umberto Gennarini, Silvia Mei, Federico Salvi, Aldo Am J Emerg Med Article INTRODUCTION: Little is known on prevalence of early return hospital admission of subjects with COVID-19 previously evaluated and discharged from emergency departments (EDs). This study aims to describe readmission rate within 14 days of patients with COVID-19 discharged from ED and to identify predictors of return hospital admission. METHODS: We performed a retrospective cohort study of adult patients with COVID-19 discharged from two EDs. Return hospital admission was defined as an unscheduled return ED visit within 14 days after initial ED evaluation and discharge. We compared the group of patients who had a return hospital admission to those who did not. We also evaluated selected clinical characteristics (age, neutrophilia, SOFA, lactate dehydrogenase, C-reactive protein and D-dimer) associated with return hospital admission. RESULTS: Of 283 patients included in the study, 65 (22.9%) had a return ED visit within 14 days. 32 of those patients (11%) were then hospitalized, while the remaining 33 were again discharged. Patients requiring a return hospital admission was significantly older, had higher pro-calcitonin and D-dimer levels. Major predictors of return hospital admission were cognitive impairment (OR 17.3 [CI 4.7–63.2]), P/F < 300 mmHg (OR 8.6 [CI 1.6–44.3]), being resident in geriatric care facility (OR 7.6 [CI 2.1–26.4]) and neutrophilia (OR 5.8 [CI 1.6–22.0]). CONCLUSION: Several factors are associated with 14-day return hospital admission in COVID-19 subjects. These should be considered when assessing discharge risk in ED clinical practice. Elsevier Inc. 2021-08 2021-04-22 /pmc/articles/PMC8061182/ /pubmed/33932638 http://dx.doi.org/10.1016/j.ajem.2021.04.055 Text en © 2021 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Menditto, Vincenzo G. Fulgenzi, Francesca Bonifazi, Martina Gnudi, Umberto Gennarini, Silvia Mei, Federico Salvi, Aldo Predictors of readmission requiring hospitalization after discharge from emergency departments in patients with COVID-19 |
title | Predictors of readmission requiring hospitalization after discharge from emergency departments in patients with COVID-19 |
title_full | Predictors of readmission requiring hospitalization after discharge from emergency departments in patients with COVID-19 |
title_fullStr | Predictors of readmission requiring hospitalization after discharge from emergency departments in patients with COVID-19 |
title_full_unstemmed | Predictors of readmission requiring hospitalization after discharge from emergency departments in patients with COVID-19 |
title_short | Predictors of readmission requiring hospitalization after discharge from emergency departments in patients with COVID-19 |
title_sort | predictors of readmission requiring hospitalization after discharge from emergency departments in patients with covid-19 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061182/ https://www.ncbi.nlm.nih.gov/pubmed/33932638 http://dx.doi.org/10.1016/j.ajem.2021.04.055 |
work_keys_str_mv | AT mendittovincenzog predictorsofreadmissionrequiringhospitalizationafterdischargefromemergencydepartmentsinpatientswithcovid19 AT fulgenzifrancesca predictorsofreadmissionrequiringhospitalizationafterdischargefromemergencydepartmentsinpatientswithcovid19 AT bonifazimartina predictorsofreadmissionrequiringhospitalizationafterdischargefromemergencydepartmentsinpatientswithcovid19 AT gnudiumberto predictorsofreadmissionrequiringhospitalizationafterdischargefromemergencydepartmentsinpatientswithcovid19 AT gennarinisilvia predictorsofreadmissionrequiringhospitalizationafterdischargefromemergencydepartmentsinpatientswithcovid19 AT meifederico predictorsofreadmissionrequiringhospitalizationafterdischargefromemergencydepartmentsinpatientswithcovid19 AT salvialdo predictorsofreadmissionrequiringhospitalizationafterdischargefromemergencydepartmentsinpatientswithcovid19 |