The role of after-hours house-call medical service in the treatment of COVID-19 patients awaiting hospital admission: A retrospective cohort study.
The role of after-hours house-call medical service in the treatment of COVID-19 patients awaiting hospital admission: A retrospective cohort study.
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下班后家庭医疗服务在等待医院入院的Covid-19患者治疗中的作用：回顾性队列研究。
DOI：
10.1097/md.0000000000028835
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发表时间：
2022-02-11
期刊：
影响因子：
1.6
通讯作者：
Tamiya N
中科院分区：
文献类型：
--
作者：
Inokuchi R;Jin X;Iwagami M;Ishikawa M;Tamiya N
由于日本冠状病毒病2019年(新冠肺炎)病例不断增加，医院无法提供入院和即时住院护理。下班后上门服务(AHHC)为等待入院的患者提供电话咨询和居家护理。目前，还没有关于住院床位不足时对新冠肺炎患者进行管理的报道。我们旨在描述2021年4月至5月(在日本的第四波期间)在大阪和东京接受AHHC医疗服务的新冠肺炎患者的临床特征和结果。根据日本指南，根据感染的严重程度，患者被分为两组：中度I组和中度II组。对医院记录进行了回顾性研究，并进行了后续电话咨询。AHHC总共治疗了55名新冠肺炎患者(17名中度I级，38名中度II级)。中位年龄(四分位数范围)分别为63岁(49~80.5岁)和(50.8~81岁)。在每组中，大约30%的AHHC患者在治疗期间接受院外氧疗，直到不再需要为止。中度I组的主要症状包括呼吸短促或呼吸困难(47.1%和78.9%)和发热或寒战(41.2%和76.3%)均低于中度II组。总体而言，16.4%的患者死亡，其中中度I组17.6%，中度II组15.8%。我们发现，接受AHHC治疗的患者的死亡率略高于在日本医院接受治疗的患者。这项研究将为在医院床位短缺的情况下需要氧气的患者提供另一种处理方法。
Due to the increasing number of coronavirus disease 2019 (COVID-19) cases in Japan, hospitals are unable to provide admission and immediate inpatient care. The after-hours house call (AHHC) service offers telephone consultations and in-home care to patients awaiting admission. Currently, there is no report on the management of COVID-19 patients when inpatient beds are insufficient. We aimed to describe the clinical characteristics and outcomes of COVID-19 patients treated by an AHHC medical service in Osaka and Tokyo, between April and May 2021 (during the fourth wave in Japan). Patients were classified into 2 groups: Moderate I and Moderate II, according to the severity of infection under Japanese guidelines. A retrospective study of the hospital records and follow-up telephone consultations was performed. The AHHC treated a total of 55 COVID-19 patients (17 with Moderate I, 38 with Moderate II disease). The median ages (interquartile range) were 63 (49–80.5) and 64 (50.8–81), respectively. In each group, approximately 30% of AHHC patients received out-of-hospital oxygen therapy for the duration of their treatment until it was no longer required. Major symptoms, including shortness of breath or difficulty breathing (47.1% and 78.9%, respectively) and fever or chills (41.2% and 76.3%, respectively) were lower in the Moderate I group than in the Moderate II group. Overall, 16.4% of patients died, with 17.6% in the Moderate I group and 15.8% in the Moderate II group. We found the proportion of mortality in patients treated by the AHHC was slightly higher to that of patients treated in Japanese hospitals. This study will provide an alternative management of patients requiring oxygen in situations where hospital beds are in short supply.
影响因子：
2.5
作者：
Inokuchi R;Morita K;Jin X;Ishikawa M;Tamiya N
通讯作者：
Tamiya N