Readmissions among patients with COVID-19
Readmissions among patients with COVID-19
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DOI：
10.1111/ijcp.13700
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发表时间：
2020-10-12
影响因子：
2.6
通讯作者：
Mylonakis, Eleftherios
中科院分区：
文献类型：
--
作者：
Atalla, Eleftheria;Kalligeros, Markos;Mylonakis, Eleftherios
背景再入院与患者预后不良和卫生资源利用率增加有关。在大流行期间，研究再入院模式的必要性甚至更大，因为负担正在进一步拉伸医疗保健系统。方法我们回顾了2020年3月1日至4月19日美国罗得岛最大的全州医院网络中19名确诊COVID-19患者的首次住院和随后的再入院情况。我们还比较了再入院和非再入院患者的特征和临床结局。结果在339名住院的COVID-19患者中，279人活着出院。其中，19/279（6.8%）在中位数5天后再次入院。与非再入院患者相比，再入院患者中高血压、糖尿病、慢性肺病、肝病、癌症和药物滥用的发生率明显较高。出院后12天内发生的再入院最常见的原因包括呼吸窘迫和血栓形成发作，而随后发生的原因包括精神疾病加重和福尔斯。再入院期间的住院时间长于首次入院期间，对医疗资源的要求更高。结论在COVID-19住院患者中，再次入院患者的合并症负担高于非再次入院患者。在出院后的前12天内，再入院原因更有可能与COVID-19有关，而之后发生的再入院原因则与其他原因有关。再入院特征可以帮助确定患者出院的最佳时机，并确保安全的护理过渡。
Background Hospital readmissions are associated with poor patient outcomes and increased health resource utilisation. The need to study readmission patterns is even bigger during a pandemic because the burden is further stretching the healthcare system. Methods We reviewed the initial hospitalisation and subsequent readmission for 19 patients with confirmed COVID-19 in the largest statewide hospital network in Rhode Island, US, from March 1st through April 19th, 2020. We also compared the characteristics and clinical outcomes between readmitted and non-readmitted patients. Results Of the 339 hospitalised patients with COVID-19, 279 discharged alive. Among them, 19/279 were readmitted (6.8%) after a median of 5 days. There was a significantly higher rate of hypertension, diabetes, chronic pulmonary disease, liver disease, cancer and substance abuse among the readmitted compared with non-readmitted patients. The most common reasons of readmissions happening within 12 days from discharge included respiratory distress and thrombotic episodes, while those happening at a later time included psychiatric illness exacerbations and falls. The length of stay during readmission was longer than during index admission and more demanding on healthcare resources. Conclusion Among hospitalised patients with COVID-19, those readmitted had a higher burden of comorbidities than the non-readmitted. Within the first 12 days from discharge, readmission reasons were more likely to be associated with COVID-19, while those happening later were related to other reasons. Readmissions characterisation may help in defining optimal timing for patient discharge and ensuring safe care transition.