Thirty-Day Post-Discharge Outcomes Following COVID-19 Infection.
Thirty-Day Post-Discharge Outcomes Following COVID-19 Infection.
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DOI：
10.1007/s11606-021-06924-0
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发表时间：
2021-08
影响因子：
5.7
通讯作者：
Goyal P
中科院分区：
文献类型：
--
作者：
Kingery JR;Bf Martin P;Baer BR;Pinheiro LC;Rajan M;Clermont A;Pan S;Nguyen K;Fahoum K;Wehmeyer GT;Alshak MN;Li HA;Choi JJ;Shapiro MF;McNairy ML;Safford MM;Goyal P
COVID-19的临床病程包括多个疾病阶段。描述出院后结果的数据可以提供对疾病病程的深入了解。描述COVID-19感染后成人住院后结果的研究仅限于电子病历审查，这可能低估了结果的发生率。确定COVID-19感染后住院30天的结果。纽约市第四系转诊医院和社区医院回顾性队列研究。2020年3月3日至5月15日期间，新冠肺炎感染患者从急诊科或医院活着出院。结果包括返回急诊科、再次住院和出院30天内的死亡率。94.6%的符合条件的患者成功收集了30天的随访数据。在1344名患者中，16.5%返回急诊室，9.8%再次住院，2.4%死亡。在返回急诊科的患者中，50.0%（108/216）的患者去了与指标表现不同的医院，61.1%（132/216）的患者再次住院。在使用lasso方法调整变量的Cox模型中，指数呈现期间年龄（HR 1.01 /年[95% CI 1.00-1.02]）、糖尿病（HR 1.54[1.06-2.23]）和住院透析需求（HR 3.78[2.23-6.43]）与较高的再住院率独立相关。年龄（HR 1.08[1.05-1.11]）和亚洲种族（HR 2.89[1.27-6.61]）与死亡率显著相关。在COVID-19指数表现后活着出院的患者中，出院后30天内再次住院的风险很大。这些患者需要密切的出院后随访以优化预后。在线版本包含补充材料，可在10.1007/s11606-021-06924-0获得。
The clinical course of COVID-19 includes multiple disease phases. Data describing post-hospital discharge outcomes may provide insight into disease course. Studies describing post-hospitalization outcomes of adults following COVID-19 infection are limited to electronic medical record review, which may underestimate the incidence of outcomes. To determine 30-day post-hospitalization outcomes following COVID-19 infection. Retrospective cohort study Quaternary referral hospital and community hospital in New York City. COVID-19 infected patients discharged alive from the emergency department (ED) or hospital between March 3 and May 15, 2020. Outcomes included return to an ED, re-hospitalization, and mortality within 30 days of hospital discharge. Thirty-day follow-up data were successfully collected on 94.6% of eligible patients. Among 1344 patients, 16.5% returned to an ED, 9.8% were re-hospitalized, and 2.4% died. Among patients who returned to the ED, 50.0% (108/216) went to a different hospital from the hospital of the index presentation, and 61.1% (132/216) of those who returned were re-hospitalized. In Cox models adjusted for variables selected using the lasso method, age (HR 1.01 per year [95% CI 1.00–1.02]), diabetes (1.54 [1.06–2.23]), and the need for inpatient dialysis (3.78 [2.23–6.43]) during the index presentation were independently associated with a higher re-hospitalization rate. Older age (HR 1.08 [1.05–1.11]) and Asian race (2.89 [1.27–6.61]) were significantly associated with mortality. Among patients discharged alive following their index presentation for COVID-19, risk for returning to a hospital within 30 days of discharge was substantial. These patients merit close post-discharge follow-up to optimize outcomes. The online version contains supplementary material available at 10.1007/s11606-021-06924-0.
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