Erschienen in:
19.08.2020 | COVID-19 | Original Research
Zur Zeit gratis
Characterization of Patients Who Return to Hospital Following Discharge from Hospitalization for COVID-19
verfasst von:
Sulaiman S. Somani, BS, Felix Richter, PhD, Valentin Fuster, MD, PhD, Jessica K. De Freitas, BS, Nidhi Naik, BS, Keith Sigel, MD, PhD, Erwin P Bottinger, MD, Matthew A. Levin, MD, Zahi Fayad, PhD, Allan C. Just, PhD, Alexander W. Charney, MD, PhD, Shan Zhao, MD, PhD, Benjamin S. Glicksberg, PhD, Anuradha Lala, MD, Girish N. Nadkarni, MD, MPH, The Mount Sinai COVID Informatics Center
Erschienen in:
Journal of General Internal Medicine
|
Ausgabe 10/2020
Einloggen, um Zugang zu erhalten
Abstract
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; Padjusted = 0.006), and were less likely to have required intensive care on index hospitalization (5.8% vs 19%; Padjusted = 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%, Padjusted = 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.