Hospital readmissions and post-discharge all-cause mortality in COVID-19 recovered patients; A systematic review and meta-analysis.
Hospital readmissions and post-discharge all-cause mortality in COVID-19 recovered patients; A systematic review and meta-analysis.
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DOI：
10.1016/j.ajem.2021.10.059
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发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Ramzi ZS
中科院分区：
文献类型：
--
作者：
Ramzi ZS
本研究旨在对康复的COVID-19患者一年再入院率和出院后全因死亡率进行系统回顾和荟萃分析。此外，还调查了结果在国家一级的流行程度。在Medline （PubMed）、Embase、Scopus和Web of Science数据库中进行了广泛的搜索，直到2021年8月3日。在谷歌和谷歌Scholar搜索引擎中进行人工搜索。包括队列研究和横断面研究。两名独立审稿人筛选了论文，收集了数据，并评估了偏倚风险和证据水平。任何分歧都是通过讨论解决的。共纳入91篇文章。48项研究调查了医院再入院情况；9项研究评估了出院后的全因死亡率，34项研究检查了两种结果。分析显示，出院后30天、90天和1年内的再入院率分别为8.97% （95% CI: 7.44、10.50）、9.79% （95% CI: 8.37、11.24）和10.34% （95% CI: 8.92、11.77）。出院后30天、90天和1年的全因死亡率分别为7.87% （95% CI: 2.78、12.96）、7.63% （95% CI: 4.73、10.53）和7.51% （95% CI: 5.30、9.72）。30天再入院率和出院后死亡率分别为8.97%和7.87%。再入院率最高的国家为德国（15.5%）、希腊（15.5%）、英国（13.5%）、荷兰（11.7%）、中国（10.8%）、美国（10.0%）和瑞典（9.9%）。此外，意大利（12.7%）、英国（11.8%）和伊朗（9.2%）的出院后全因死亡率最高。敏感性分析显示，高质量研究中1年再入院率和出院后全因死亡率分别为10.38%和4.00%。10.34%的康复患者出院后需要再入院。大多数再入院和死亡病例似乎发生在出院后30天内。COVID-19患者出院后1年全因死亡率为7.87%，大多数患者的再入院和死亡发生在出院后的前30天。因此，有必要建立出院患者的30天随访计划和患者追踪系统。
The present study aimed to perform a systematic review and meta-analysis on the prevalence of one-year hospital readmissions and post-discharge all-cause mortality in recovered COVID-19 patients. Moreover, the country-level prevalence of the outcomes was investigated. An extensive search was performed in Medline (PubMed), Embase, Scopus, and Web of Science databases until the end of August 3rd, 2021. A manual search was also performed in Google and Google Scholar search engines. Cohort and cross-sectional studies were included. Two independent reviewers screened the papers, collected data, and assessed the risk of bias and level of evidence. Any disagreement was resolved through discussion. 91 articles were included. 48 studies examined hospital readmissions; nine studies assessed post-discharge all-cause mortality, and 34 studies examined both outcomes. Analyses showed that the prevalence of hospital readmissions during the first 30 days, 90 days, and one-year post-discharge were 8.97% (95% CI: 7.44, 10.50), 9.79% (95% CI: 8.37, 11.24), and 10.34% (95% CI: 8.92, 11.77), respectively. The prevalence of post-discharge all-cause mortality during the 30 days, 90 days and one-year post-discharge was 7.87% (95% CI: 2.78, 12.96), 7.63% (95% CI: 4.73, 10.53) and 7.51% (95% CI, 5.30, 9.72), respectively. 30-day hospital readmissions and post-discharge mortality were 8.97% and 7.87%, respectively. The highest prevalence of hospital readmissions was observed in Germany (15.5%), Greece (15.5%), UK (13.5%), Netherlands (11.7%), China (10.8%), USA (10.0%) and Sweden (9.9%). In addition, the highest prevalence of post-discharge all-cause mortality belonged to Italy (12.7%), the UK (11.8%), and Iran (9.2%). Sensitivity analysis showed that the prevalence of one-year hospital readmissions and post-discharge all-cause mortality in high-quality studies were 10.38% and 4.00%, respectively. 10.34% of recovered COVID-19 patients required hospital readmissions after discharge. Most cases of hospital readmissions and mortality appear to occur within 30 days after discharge. The one-year post-discharge all-cause mortality rate of COVID-19 patients is 7.87%, and the majority of patients' readmission and mortality happens within the first 30 days post-discharge. Therefore, a 30-day follow-up program and patient tracking system for discharged COVID-19 patients seems necessary.
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An J;Liao X;Xiao T;Qian S;Yuan J;Ye H;Qi F;Shen C;Wang L;Liu Y;Cheng X;Li N;Cai Q;Wang F;Chen J;Li G;Cai Q;Liu Y;Wang Y;Zhang F;Fu Y;He Q;Tan X;Liu L;Zhang Z
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