Characterization of Patients Who Return to Hospital Following Discharge from Hospitalization for COVID-19
Characterization of Patients Who Return to Hospital Following Discharge from Hospitalization for COVID-19
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DOI：
10.1007/s11606-020-06120-6
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发表时间：
2020-08-19
影响因子：
5.7
通讯作者：
Nadkarni, Girish N.
中科院分区：
文献类型：
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作者：
Somani, Sulaiman S.;Richter, Felix;Nadkarni, Girish N.
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 asP< 0.05 after multiplyingPby 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.
