The risk of death or unplanned readmission after discharge from a COVID-19 hospitalization in Alberta and Ontario.
The risk of death or unplanned readmission after discharge from a COVID-19 hospitalization in Alberta and Ontario.
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DOI：
10.1503/cmaj.220272
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发表时间：
2022-05-16
期刊：
影响因子：
--
通讯作者：
中科院分区：
文献类型：
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COVID-19住院后再入院的频率尚不确定，目前的再入院预测方程是否可用于COVID-19幸存者的出院风险分层或用于医院之间的比较。我们试图确定COVID-19出院后死亡或计划外再入院的频率和预测因素。我们对2020年1月1日至2020年9月19日期间因COVID-19接受非精神病、非产科、急性护理入院后活着出院的所有成人（≥ 18岁）进行了一项回顾性队列研究。30，2021年，在阿尔伯塔和安大略。在研究期间，通过逆转录聚合酶链反应检测出SARS-CoV-2阳性的843737人中，有46412人（5.5%）是在阳性检测后14天内入院的成年人。其中，8496人在医院死亡，34846人活着出院（30336人在入院≤ 30 d后出院，4510人在入院> 30 d后出院）。9例出院患者中有1例在出院后30天内死亡或再次入院（住院≤ 30 d的患者中有3173例[10.5%]，住院> 30 d的患者中有579例[12.8%]）。预测30天内紧急再入院或死亡的LACE评分（住院时间、视力、Charlson Comorbid指数和前6个月急诊就诊次数）的c-统计量在阿尔伯塔为0.60，在安大略为0.61;模型中纳入性别、出院地点、剥夺指数和教学医院状态将c-统计量提高至0.73。COVID-19住院治疗出院后死亡或再次入院很常见，在阿尔伯塔和安大略的频率相似。除了LACE变量外，对COVID-19入院后结局的风险分层和机构间比较还应包括性别、出院地点和社会经济指标。
The frequency of readmissions after COVID-19 hospitalizations is uncertain, as is whether current readmission prediction equations are useful for discharge risk stratification of COVID-19 survivors or for comparing among hospitals. We sought to determine the frequency and predictors of death or unplanned readmission after a COVID-19 hospital discharge. We conducted a retrospective cohort study of all adults (≥ 18 yr) who were discharged alive from hospital after a nonpsychiatric, nonobstetric, acute care admission for COVID-19 between Jan. 1, 2020, and Sept. 30, 2021, in Alberta and Ontario. Of 843 737 individuals who tested positive for SARS-CoV-2 by reverse transcription polymerase chain reaction during the study period, 46 412 (5.5%) were adults admitted to hospital within 14 days of their positive test. Of these, 8496 died in hospital and 34 846 were discharged alive (30 336 discharged after an index admission of ≤ 30 d and 4510 discharged after an admission > 30 d). One in 9 discharged patients died or were readmitted within 30 days after discharge (3173 [10.5%] of those with stay ≤ 30 d and 579 [12.8%] of those with stay > 30 d). The LACE score (length of stay, acuity, Charlson Comorbidity Index and number of emergency visits in previous 6 months) for predicting urgent readmission or death within 30 days had a c-statistic of 0.60 in Alberta and 0.61 in Ontario; inclusion of sex, discharge locale, deprivation index and teaching hospital status in the model improved the c-statistic to 0.73. Death or readmission after discharge from a COVID-19 hospitalization is common and had a similar frequency in Alberta and Ontario. Risk stratification and interinstitutional comparisons of outcomes after hospital admission for COVID-19 should include sex, discharge locale and socioeconomic measures, in addition to the LACE variables.
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影响因子：
39.2
作者：
Kind AJ;Bartels C;Mell MW;Mullahy J;Smith M
通讯作者：
Smith M
影响因子：
4.6
作者：
Ramos-Martínez A;Parra-Ramírez LM;Morrás I;Carnevali M;Jiménez-Ibañez L;Rubio-Rivas M;Arnalich F;Beato JL;Monge D;Asín U;Suárez C;Freire SJ;Méndez-Bailón M;Perales I;Loureiro-Amigo J;Gómez-Belda AB;Pesqueira PM;Gómez-Huelgas R;Mella C;Díez-García LF;Fernández-Sola J;González-Ferrer R;Aroza M;Antón-Santos JM;Bermejo CL
通讯作者：
Bermejo CL
DOI：
10.1016/j.ajem.2021.10.059
发表时间：
2022-01
期刊：
The American journal of emergency medicine
影响因子：
--
作者：
Ramzi ZS
通讯作者：
Ramzi ZS
DOI：
10.15585/mmwr.mm6945e2
发表时间：
2020-11-13
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Lavery AM;Preston LE;Ko JY;Chevinsky JR;DeSisto CL;Pennington AF;Kompaniyets L;Datta SD;Click ES;Golden T;Goodman AB;Mac Kenzie WR;Boehmer TK;Gundlapalli AV
通讯作者：
Gundlapalli AV
影响因子：
13.8
作者：
Roth GA;Emmons-Bell S;Alger HM;Bradley SM;Das SR;de Lemos JA;Gakidou E;Elkind MSV;Hay S;Hall JL;Johnson CO;Morrow DA;Rodriguez F;Rutan C;Shakil S;Sorensen R;Stevens L;Wang TY;Walchok J;Williams J;Murray C
通讯作者：
Murray C